Individual provider Active NPI

Sophia Marie York

  • Speech-Language Pathologist
  • Fort Wayne, IN
National Provider Identifier
1346042918
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22009031A Issued in IN
Practice address
4625 Amity Dr Apt 304
Fort Wayne, IN 46845-9816
Phone
(260) 431-7625
NPI assigned
Mar 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 22009031A IN Primary
Speech-Language Pathologist 235Z00000X 39391 CA

Addresses

Primary practice location

4625 Amity Dr Apt 304
Fort Wayne, IN 46845-9816

Mailing address

4625 Amity Dr Apt 304
Fort Wayne, IN 46845-9816

Other practice location 1

5700 Village Oaks Dr Apt 1431
San Jose, CA 95123-3780
Phone (260) 431-7625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609001815 IN Practitioner - Qualified Speech Language Pathologist 2769992817 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22009031AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Sep 1, 2025 Accepting new patients
Auburn Senior Living LLC CurrentSince Mar 30, 2025 Accepting new patients
Cortlyn Therapy, PC Speech-Language Pathologist CurrentSince May 13, 2025 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Sep 1, 2025 Accepting new patients

Locations

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

1675 W 7th St
Auburn, IN 46706
Phone (260) 247-6632

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

10 S 9th St
Ste 4
Noblesville, IN 46060

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": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1346042918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 AMITY DR APT 304",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 AMITY DR APT 304",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459816",
            "telephone_number": "260-431-7625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Village Oaks Dr Apt 1431",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951233780",
            "country_code": "US",
            "telephone_number": "260-431-7625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YORK",
        "first_name": "SOPHIA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22009031A",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "39391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.