Individual provider Active NPI

Annette M Mehta, M.A., M.ED.,CCC-SLP

  • Speech-Language Pathologist
  • Murfreesboro, TN
National Provider Identifier
1104012152
Registry record updated Sep 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SPOOO212 Issued in TN
Practice address
1840 Heritage Park PLZ
Murfreesboro, TN 37129-1575
Phone
(615) 890-0935
NPI assigned
Sep 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 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 SPOOO212 TN Primary

Addresses

Primary practice location

1840 Heritage Park PLZ
Murfreesboro, TN 37129-1575

Mailing address

PO Box 1311
Murfreesboro, TN 37133-1311
Phone (615) 890-0935

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
Credentials
Master of Arts, Master of Education

State licenses

LicenseStateTypeSpecialty
SPOOO212TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1190419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190419200000",
    "number": "1104012152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1311",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371331311",
            "telephone_number": "615-890-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 HERITAGE PARK PLZ",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291575",
            "telephone_number": "615-890-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "ANNETTE",
        "middle_name": "M",
        "credential": "M.A., M.ED.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-22",
        "last_updated": "2007-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SPOOO212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.