Individual provider Active NPI

Ala Y Omar, CCC-SLP

  • Speech-Language Pathologist
  • Worthington, OH
National Provider Identifier
1396254835
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.14607 Issued in OH
Practice address
951 High St Lowr Level
Worthington, OH 43085-4099
Phone
(956) 237-6894
Fax
(614) 670-7427
NPI assigned
Sep 27, 2017
Last updated
Oct 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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 SP.14607 OH Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

951 High St Lowr Level
Worthington, OH 43085-4099

Mailing address

951 High St Lowr Level
Worthington, OH 43085-4099
Phone (956) 237-6894

Other identifiers 1

IdentifierTypeStateIssuer
0306774MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.fusionwebclinic.com

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.14607OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Haugland Learning Center Past Accepting new patients
Casa Speech, LLC Speech-Language Pathologist PastSince Oct 10, 2021 Accepting new patients

Organizations & group practices 2

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1396254835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 HIGH ST LOWR LEVEL",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854099",
            "telephone_number": "956-237-6894",
            "fax_number": "614-670-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 HIGH ST LOWR LEVEL",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854099",
            "telephone_number": "956-237-6894",
            "fax_number": "614-670-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMAR",
        "first_name": "ALA",
        "middle_name": "Y",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.14607",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0306774",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.fusionwebclinic.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "951 High St Lowr Level",
            "city": "Worthington",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430854099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 4, 2021; 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.