Individual provider Active NPI

Madelyn Anderson, SLP

  • Speech-Language Pathologist
  • Copley, OH
National Provider Identifier
1265073787
Registry record updated Oct 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP13371 Issued in OH
Practice address
2754 Loch Raven Blvd Apt H
Copley, OH 44321-2162
Phone
(330) 907-1160
NPI assigned
Oct 6, 2019
Last updated
Oct 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2019

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 SP13371 OH Primary

Addresses

Primary practice location

2754 Loch Raven Blvd Apt H
Copley, OH 44321-2162

Mailing address

2754 Loch Raven Blvd Apt H
Copley, OH 44321-2162
Phone (330) 907-1160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106003222 OH Practitioner - Qualified Speech Language Pathologist 2860824166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19455 Rockside Rd
Bedford, OH 44146-2000
Phone (440) 305-7511

8180 Mentor Hills Dr
Mentor, OH 44060-7815
Phone (440) 491-6820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Oct 1, 2019 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Oct 1, 2019 Accepting new patients

Organizations & group practices 3

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": "1570320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570320000000",
    "number": "1265073787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2754 LOCH RAVEN BLVD APT H",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443212162",
            "telephone_number": "330-907-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2754 LOCH RAVEN BLVD APT H",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443212162",
            "telephone_number": "330-907-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MADELYN",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-06",
        "last_updated": "2019-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP13371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Copley, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.