Dana Marie Fennell, MSED, MS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

020545-1 Issued in NY

Practice address

2814 Gray Fox Rd
Monroe, NC 28110-8422

Phone

(704) 821-0568

Fax

(704) 821-0570

NPI assigned

Apr 29, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Pediatric Boulevard, PLLC

  • Speech-Language Pathologist
  • Monroe, NC
  • NPI 1114233590
  NPD (past)

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557619200000",
    "number": "1144547274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 GRAY FOX RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281108422",
            "telephone_number": "704-821-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 GRAY FOX RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281108422",
            "telephone_number": "704-821-0568",
            "fax_number": "704-821-0570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 Morris Park Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611915",
            "country_code": "US",
            "telephone_number": "718-430-3830 x6221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "credential": "MSED, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-29",
        "last_updated": "2019-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020545-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Luke Farmer, MD
• Joseph Farrug, PA
• Elizabeth W Feild, SLP
• Bradford Feldman, MD
• Tony Kona Fele, RN
• Ashley Martinez Fento, MD
• Jessica Marie Fenyves
• Brooke Ferri
• Caryn Fidalgo, OT
• Shanila Patel Fields, PA-C

• Speech-Language Pathologist in Monroe, NC
• Providers in Monroe, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2019; 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.