Individual provider Active NPI

Alyssa Tatum

  • Speech-Language Pathologist
  • Cincinnati, OH
National Provider Identifier
1285188284
Registry record updated Aug 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.12610 Issued in OH
Practice address
1826 Fairfax Ave Apt 1
Cincinnati, OH 45207
Phone
(937) 760-0289
NPI assigned
Aug 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2018

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 SP.12610 OH Primary

Addresses

Primary practice location

1826 Fairfax Ave Apt 1
Cincinnati, OH 45207

Mailing address

1826 Fairfax Ave Apt 1
Cincinnati, OH 45207-1812
Phone (937) 760-0289

Other practice location 1

6281 Tri Ridge Blvd
Suite 100
Loveland, OH 45140-8345
Phone (866) 474-6677

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

LicenseStateTypeSpecialty
SP.12610OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534032000000",
    "number": "1285188284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 FAIRFAX AVE APT 1",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452071812",
            "telephone_number": "937-760-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 FAIRFAX AVE APT 1",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45207",
            "telephone_number": "937-760-0289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6281 Tri Ridge Blvd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "OH",
            "postal_code": "451408345",
            "country_code": "US",
            "telephone_number": "866-474-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2018-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.12610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2018; 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.