NPIMap

Individual provider Active NPI

Christi Star O'Donovan, M.S.,CCC-SLP

  • Speech-Language Pathologist
  • Braintree, MA
National Provider Identifier
1356669303
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
751 Granite St
Braintree, MA 02184-5328
Phone
(781) 380-4360
NPI assigned
May 13, 2010
Last updated
Jun 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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 Primary
Developmental Therapist 222Q00000X

Addresses

Primary practice location

751 Granite St
Braintree, MA 02184-5328

Mailing address

22 Bradley Rd
Braintree, MA 02184-4921
Phone (631) 560-9970

Other names 1

  • Christi Star Berglund 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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Leading Therapy Home, LLC Speech-Language Pathologist Current Accepting new patients
FS Patriot LLC Past Accepting new patients
Encompass Health Rehabilitation Hospital of Braintree, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1356669303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRADLEY RD",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021844921",
            "telephone_number": "631-560-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 GRANITE ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845328",
            "telephone_number": "781-380-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONOVAN",
        "first_name": "CHRISTI",
        "middle_name": "STAR",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTI",
            "last_name": "BERGLUND",
            "middle_name": "STAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Braintree, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.