Individual provider Active NPI

Gloria Stansberry, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Cleveland, OH
National Provider Identifier
1164557732
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3409 Issued in OH
Practice address
4553 Hinckley Industrial Pkwy
Cleveland, OH 44109-6009
Phone
(216) 635-3502
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3409 OH Primary

Addresses

Primary practice location

4553 Hinckley Industrial Pkwy
Cleveland, OH 44109-6009

Mailing address

6222 Brookside Dr
Cleveland, OH 44144-1633
Phone (216) 398-8226

Other identifiers 1

IdentifierTypeStateIssuer
CO9368691OtherOHMEDICARE PTAN

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3409OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Cuyahoga Past Accepting new patients

Organizations & group practices 1

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1164557732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 BROOKSIDE DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441441633",
            "telephone_number": "216-398-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 HINCKLEY INDUSTRIAL PKWY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441096009",
            "telephone_number": "216-635-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANSBERRY",
        "first_name": "GLORIA",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "3409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CO9368691",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.