Individual provider Active NPI

Jane Kathryn Stahl, CF, CCC-SLP

  • Speech-Language Pathologist
  • Worthington, OH
National Provider Identifier
1376218362
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20211800 Issued in OH
Practice address
445 E Dublin Granville Rd
Worthington, OH 43085-3192
Phone
(614) 844-3800
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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 20211800 OH Primary

Addresses

Primary practice location

445 E Dublin Granville Rd
Worthington, OH 43085-3192

Mailing address

445 E Dublin Granville Rd
Worthington, OH 43085-3192
Phone (614) 844-3800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927002000 OH Practitioner - Qualified Speech Language Pathologist 2860878964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20211800OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boundless Health, Inc. Speech-Language Pathologist Current Accepting new patients
Boundless Health, Inc. CurrentSince Jun 17, 2022 Accepting new patients
Boundless Health, Inc. CurrentSince Jun 17, 2022 Accepting new patients
Boundless Health, Inc. Past Accepting new patients

Locations

140 W Church St
Newark, OH 43055
Phone (740) 334-4056

445 E Granville Rd
Ste G
Worthington, OH 43085
Phone 61484438002224

445 E Dublin Granville Rd
Worthington, OH 43085
Phone (614) 844-3100

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1376218362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E DUBLIN GRANVILLE RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853192",
            "telephone_number": "614-844-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E DUBLIN GRANVILLE RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853192",
            "telephone_number": "614-844-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "JANE",
        "middle_name": "KATHRYN",
        "credential": "CF, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "20211800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.