Michelle Dawn Sanborn, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5141 Issued in OH

Practice address

16349 Beaver Pike
Jackson, OH 45640-8511

Phone

(740) 286-2790

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson City School District

  • Local Education Agency (LEA)
  • Jackson, OH
  • NPI 1689814162
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124192760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 VAUGHN ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16349 BEAVER PIKE",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456408511",
            "telephone_number": "740-286-2790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Pattonsville Road",
            "address_purpose": "LOCATION",
            "city": "Gallipolis",
            "state": "OH",
            "postal_code": "45631",
            "country_code": "US",
            "telephone_number": "740-395-8801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "5141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "5141",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helen Royster
• J F Rupert, DSC, PHD, DD
• Timothy Matthew Ryan, CMS
• Jillian Nicole Salmons, LISW
• Gregory Sammons, LPCC
• Tabitha L Scarbrough, CDCA
• Bruce Patrick Schaffner II
• Jamie Lynn Schrader
• Tracy Dawn Schuh, LCDCIII
• Zachary Schumacher

• Speech-Language Pathologist in Jackson, OH
• Providers in Jackson, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.