Pennsylvania State University

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

SL010567 Issued in PA

Legal business name

PENNSYLVANIA STATE UNIVERSITY

Practice address

110 Ford BLDG
The Pennsylvania State University
University Park, PA 16802-3000

Phone

(814) 865-5414

NPI assigned

Dec 13, 2011

Organization subpart

No

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

Authorized official

Name

Nimisha Muttiah

Title

Speech Language Pathologist

Phone

(419) 575-8034

Specialties & licenses 1

Addresses

Tax ID family

Pennsylvania State University2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pennsylvania State University

  • In Home Supportive Care Agency
  • University Park, PA
  • NPI 1851669667
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Megan Tobin, CCC-SLP

  • Speech-Language Pathologist
  • University Park, PA
  • NPI 1841546058
  NPD (past)

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1184992554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 TEABERRY LN",
            "address_2": "D 206",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FORD BLDG",
            "address_2": "THE PENNSYLVANIA STATE UNIVERSITY",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168023000",
            "telephone_number": "814-865-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "MUTTIAH",
        "authorized_official_first_name": "NIMISHA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "419-575-8034"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "PA",
            "license": "SL010567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Parker, PHD
• Cameron Daniel Patria, MED, ATC
• Yvonne Patterson, M.D.
• Evan G. Pattishall III, M.D.
• Luca Gianni Nicola Pedone
• Pennsylvania State University
• Emma Phillips
• Aaron Lee Pincus
• Jessica Marie Pisarcik, PA-C
• Leigh A Pitterle, RN

• Point of Service in University Park, PA
• Providers in University Park, PA by specialty
• Point of Service in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.