Patty Fenn, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1314 Issued in AL

Practice address

193 Sam Lisenby Rd
Ozark, AL 36360-3048

Phone

(334) 445-6336

Fax

(334) 445-6363

NPI assigned

Feb 12, 2007

Last updated

Feb 26, 2008By the provider in NPPES

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

Enrolled in AL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sumlar Therapy Service, Inc.

  • Physical Therapist
  • Ozark, AL
  • NPI 1265574990

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1144362930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 SAM LISENBY RD",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603048",
            "telephone_number": "334-445-6336",
            "fax_number": "334-445-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 SAM LISENBY RD",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603048",
            "telephone_number": "334-445-6336",
            "fax_number": "334-445-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENN",
        "first_name": "PATTY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "1314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51513796",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shasta J Ellenburg, PT
• Encore Rehabilitation Inc (Encore Rehab of Ozark)
• Enlighten Behavioral Consultation, LLC
• Eyecare Associates, Inc. (Eye Care Associates)
• Faith Ministry Trinity Life Family Inc
• Juan A Fernandez, MD
• Anne Marie Flannery, PT
• Joterian C Flowers, CRNP
• Kanadia Deshion Flowers
• Maddison Foss-Cormier

• Speech-Language Pathologist in Ozark, AL
• Providers in Ozark, AL by specialty
• Speech-Language Pathologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.