Individual provider Active NPI

Breann Vincent

  • Speech-Language Pathologist
  • Newark, OH
National Provider Identifier
1316361918
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-10103 Issued in OH
Practice address
621 Mount Vernon Rd
Newark, OH 43055-4615
Phone
(740) 670-7000
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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-10103 OH Primary

Addresses

Primary practice location

621 Mount Vernon Rd
Newark, OH 43055-4615

Mailing address

7245 Upper Albany Dr
New Albany, OH 43054-9111

Other names 1

  • Breann Ragor Former name

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-10103OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Newark City Schools PastSince Mar 24, 2024 Accepting new patients

Organizations & group practices 1

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1316361918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7245 UPPER ALBANY DR",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MOUNT VERNON RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430554615",
            "telephone_number": "740-670-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "BREANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-10103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANN",
            "last_name": "RAGOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.