Individual provider Active NPI

Jennifer E Sheehy, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Fairfield, OH
National Provider Identifier
1174657308
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-6041 Issued in OH
Practice address
4641 Bach LN
Fairfield, OH 45014-1900
Phone
(513) 829-6300
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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 SP-6041 OH Primary

Addresses

Primary practice location

4641 Bach LN
Fairfield, OH 45014-1900

Mailing address

4641 Bach LN
Fairfield, OH 45014-1900
Phone (513) 829-6300

Other identifiers 1

IdentifierTypeStateIssuer
000000013284OtherOHANTHEM 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
SP-6041OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield City School District PastSince May 12, 2024 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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1174657308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 BACH LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450141900",
            "telephone_number": "513-829-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 BACH LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450141900",
            "telephone_number": "513-829-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHY",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-6041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000013284",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.