Individual provider Active NPI

Mia Fioranelli, MED CCC SLP

  • Speech-Language Pathologist
  • Germantown, TN
National Provider Identifier
1235537978
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3020 Issued in TN
Practice address
2176 West St Ste 206
Germantown, TN 38138-3859
Phone
(901) 328-2110
NPI assigned
Dec 11, 2014
Last updated
Dec 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 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 3020 TN Primary

Addresses

Primary practice location

2176 West St Ste 206
Germantown, TN 38138-3859

Mailing address

2176 West St Ste 206
Germantown, TN 38138-3859
Phone (901) 328-2110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220330002444 TN Practitioner - Qualified Speech Language Pathologist 7618363615 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
3020TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Oct 2, 2023 Accepting new patients
Ave Maria Home CurrentSince Mar 21, 2022 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Oct 2, 2023 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

2805 Charles Bryan Rd
Bartlett, TN 38134
Phone (901) 386-3211

6300 Briarcrest Ave
Memphis, TN 38120
Phone (901) 386-3211

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1235537978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 WEST ST STE 206",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383859",
            "telephone_number": "901-328-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 WEST ST STE 206",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383859",
            "telephone_number": "901-328-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORANELLI",
        "first_name": "MIA",
        "credential": "MED CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "3020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.