Active NPI
Donann Kissick, MA,CCC-SLP
- Speech-Language Pathologist
- Indianapolis, IN
National Provider Identifier
1134657455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01003559
- Practice address
- 450 E 96TH St.
Suite 500
Indianapolis, IN 46240 - Phone
- (131) 776-2844
- NPI assigned
- May 31, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 01003559 | IN | Primary |
Addresses
Primary practice location
450 E 96TH St.
Suite 500
Indianapolis, IN 46240
Mailing address
3518 Innsdale Dr.
New Castle, IN 47362
Phone (765) 524-9844
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01003559 | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496188800000",
"number": "1134657455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3518 INNSDALE DR.",
"city": "NEW CASTLE",
"state": "IN",
"postal_code": "47362",
"telephone_number": "765-524-9844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 E 96TH ST.",
"address_2": "SUITE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46240",
"telephone_number": "131-776-2844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISSICK",
"first_name": "DONANN",
"name_prefix": "Mrs.",
"credential": "MA,CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-31",
"last_updated": "2017-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "01003559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.