Individual provider Active NPI

Judith Mathew

  • Speech-Language Pathologist
  • Noblesville, IN
National Provider Identifier
1417214875
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
46002282A Issued in IN
Practice address
901 Laurel LN
Noblesville, IN 46062-9142
Phone
(765) 716-5744
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 46002282A IN Primary

Addresses

Primary practice location

901 Laurel LN
Noblesville, IN 46062-9142

Mailing address

901 Laurel LN
Noblesville, IN 46062-9142
Phone (765) 716-5744

Other practice location 1

2025 W Jackson St
Muncie, IN 47303-4858
Phone (765) 716-5744

Other practice location 2

1397 Grant St
Noblesville, IN 46060-1925
Phone (765) 716-5744

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
46002282AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417214875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 LAUREL LN",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460629142",
            "telephone_number": "765-716-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LAUREL LN",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460629142",
            "telephone_number": "765-716-5744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473034858",
            "country_code": "US",
            "telephone_number": "765-716-5744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1397 Grant St",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460601925",
            "country_code": "US",
            "telephone_number": "765-716-5744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JUDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46002282A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.