Individual provider Active NPI

Autumn Leann Ringeisen, CCC-SLP

  • Speech-Language Pathologist
  • Kokomo, IN
National Provider Identifier
1275915456
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2108 E Boulevard
Kokomo, IN 46902-2401
Phone
(765) 416-8480
Fax
(765) 588-5480
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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 IN Primary

Addresses

Primary practice location

2108 E Boulevard
Kokomo, IN 46902-2401

Mailing address

PO Box 411169
Boston, MA 02241-1169
Phone (888) 830-4125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190701001679 IN Practitioner - Qualified Speech Language Pathologist 3375877988 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Sep 10, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Jul 16, 2018 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Jul 16, 2018 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Speech-Language Pathologist CurrentSince Sep 10, 2022 Accepting new patients

Locations

2108 E Boulevard
Kokomo, IN 46902
Phone (765) 416-8480

5 Broadway Plz
Peru, IN 46970
Phone (765) 327-2111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1275915456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411169",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022411169",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022401",
            "telephone_number": "765-416-8480",
            "fax_number": "765-588-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINGEISEN",
        "first_name": "AUTUMN",
        "middle_name": "LEANN",
        "name_prefix": "Miss",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.