Individual provider Active NPI

Chelsea N Nimmo, MA, CCC-SLP

  • Speech-Language Pathologist
  • Shaker Heights, OH
National Provider Identifier
1295257640
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
21897213 Issued in OH
Practice address
20600 Shaker Blvd
Shaker Heights, OH 44122-2620
Phone
(216) 295-4100
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 21897213 OH Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

20600 Shaker Blvd
Shaker Heights, OH 44122-2620

Mailing address

15130 Pine Hill TRL
Middleburg Heights, OH 44130-5511
Phone (269) 808-1813

Other practice location 1

41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone (248) 299-0030

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
21897213OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1295257640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15130 PINE HILL TRL",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441305511",
            "telephone_number": "269-808-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20600 SHAKER BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441222620",
            "telephone_number": "216-295-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41521 W 11 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751803",
            "country_code": "US",
            "telephone_number": "248-299-0030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIMMO",
        "first_name": "CHELSEA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "21897213",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.