Individual provider Active NPI

Ana Nazario Raguseo, MCD, CCC-SLP

  • Speech-Language Pathologist
  • Summerville, SC
National Provider Identifier
1083040836
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6302 Issued in SC
Practice address
500 Congressional Blvd
Summerville, SC 29483-5049
Phone
(803) 546-2575
NPI assigned
Sep 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 258827 SC
Speech-Language Pathologist 235Z00000X 6302 SC Primary

Addresses

Primary practice location

500 Congressional Blvd
Summerville, SC 29483-5049

Mailing address

500 Congressional Blvd
Summerville, SC 29483-5049
Phone (803) 546-2575

Other practice location 1

315 E Queen St
Pendleton, SC 29670-1721
Phone (864) 403-2000

Other identifiers 1

IdentifierTypeStateIssuer
1942275649MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
258827SCMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1083040836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CONGRESSIONAL BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294835049",
            "telephone_number": "803-546-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CONGRESSIONAL BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294835049",
            "telephone_number": "803-546-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 E Queen St",
            "address_purpose": "LOCATION",
            "city": "Pendleton",
            "state": "SC",
            "postal_code": "296701721",
            "country_code": "US",
            "telephone_number": "864-403-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAGUSEO",
        "first_name": "ANA",
        "middle_name": "NAZARIO",
        "name_prefix": "Mrs.",
        "credential": "MCD, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "258827",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "6302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942275649",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.