Individual provider Active NPI

Pamela Reese, MACCC SLP

  • Speech-Language Pathologist
  • Athens, OH
National Provider Identifier
1093880809
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP7901 Issued in OH
Practice address
W174 Grover Center
Ohio University Therapy Assoc
Athens, OH 45701
Phone
(740) 593-1404
Fax
(740) 593-4433
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP7901 OH Primary

Addresses

Primary practice location

W174 Grover Center
Ohio University Therapy Assoc
Athens, OH 45701

Mailing address

W174 Grover Center
Athens, OH 45701
Phone (740) 593-1404

Other identifiers 2

IdentifierTypeStateIssuer
0624471MedicaidOH
000000246469OtherOHANTHEM GRP

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
SP7901OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093880809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W174 GROVER CENTER",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "740-593-1404",
            "fax_number": "740-593-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W174 GROVER CENTER",
            "address_2": "OHIO UNIVERSITY THERAPY ASSOC",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "740-593-1404",
            "fax_number": "740-593-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "PAMELA",
        "name_prefix": "Ms.",
        "credential": "MACCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP7901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0624471",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GRP",
            "identifier": "000000246469",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.