Active NPI
Alisha Fullenkamp
- Speech-Language Pathologist
- Dublin, OH
National Provider Identifier
1245630847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.12930
- Practice address
- 5175 Emerald Pkwy
Dublin, OH 43017-1063 - Phone
- (314) 302-8967
- NPI assigned
- Sep 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP.12930 | OH | Primary |
Addresses
Primary practice location
5175 Emerald Pkwy
Dublin, OH 43017-1063
Mailing address
5038 Shannonbrook Dr
Columbus, OH 43221-5245
Phone (314) 302-8967
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP.12930 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723593600000",
"number": "1245630847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5038 SHANNONBROOK DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432215245",
"telephone_number": "314-302-8967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5175 EMERALD PKWY",
"city": "DUBLIN",
"state": "OH",
"postal_code": "430171063",
"telephone_number": "314-302-8967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLENKAMP",
"first_name": "ALISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-02",
"last_updated": "2024-08-14",
"certification_date": "2024-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.12930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.