Melodie Gray Roach, MA CCC-SLP, RAC-CT

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.04193 Issued in OH

Practice address

5520 Broadview Rd FRNT
Parma, OH 44134-1605

Phone

(216) 749-6650

Fax

(216) 749-1655

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1316966773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 ROCKSIDE RD STE 500",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312178",
            "telephone_number": "216-459-2846",
            "fax_number": "216-901-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 BROADVIEW RD FRNT",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441341605",
            "telephone_number": "216-749-6650",
            "fax_number": "216-749-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 W Liberty St",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442562221",
            "country_code": "US",
            "telephone_number": "216-749-6650",
            "fax_number": "330-723-8920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROACH",
        "first_name": "MELODIE",
        "middle_name": "GRAY",
        "credential": "MA CCC-SLP, RAC-CT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.04193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11508487",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148005",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Parma, OH
• Providers in Parma, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.