Individual provider Active NPI

Adrienne Mann, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Beavercreek, OH
National Provider Identifier
1154721082
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP11668 Issued in OH
Practice address
3817 Colonel Glenn Hwy
Beavercreek, OH 45324-2268
Phone
(937) 427-9200
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X COND.2014299-SP OH
Speech-Language Pathologist 235Z00000X SP23223 CA
Speech-Language Pathologist 235Z00000X SP11668 OH Primary

Addresses

Primary practice location

3817 Colonel Glenn Hwy
Beavercreek, OH 45324-2268

Mailing address

7591 Tylers Place Blvd
West Chester, OH 45069-6308
Phone (513) 755-6600

Other practice location 1

9680 Cincinnati Columbus Rd
West Chester, OH 45241-1071
Phone (513) 777-8599

Other practice location 2

2340 Irving St Ste 108
San Francisco, CA 94122-1639
Phone (415) 935-0412

Other identifiers 2

IdentifierTypeStateIssuer
0406425MedicaidOH
AB7360731OtherOHMEDICARE PIN

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

LicenseStateTypeSpecialty
SP23223CAMDSpeech-Language Pathologist
COND.2014299-SPOHMDSpeech-Language Pathologist
SP11668OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Concepts in Hearing Past Accepting new patients
Abc Pediatric Therapy LLC Speech-Language Pathologist PastSince Dec 22, 2019 Accepting new patients
Comprehensive Concepts in Speech and Hearing, Inc. Speech-Language Pathologist PastSince Aug 2, 2017 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1154721082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7591 TYLERS PLACE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696308",
            "telephone_number": "513-755-6600",
            "fax_number": "513-755-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 COLONEL GLENN HWY",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453242268",
            "telephone_number": "937-427-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9680 Cincinnati Columbus Rd",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "OH",
            "postal_code": "452411071",
            "country_code": "US",
            "telephone_number": "513-777-8599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2340 Irving St Ste 108",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941221639",
            "country_code": "US",
            "telephone_number": "415-935-0412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "ADRIENNE",
        "name_prefix": "Ms.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND.2014299-SP",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP23223",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP11668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0406425",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "AB7360731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.