Individual provider Active NPI

Marianne Samuel, SLP

  • Speech-Language Pathologist
  • Zionsville, IN
National Provider Identifier
1447703020
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22004442A Issued in IN
Practice address
9240 Greenthread LN
Zionsville, IN 46077
Phone
(317) 833-9974
Fax
(866) 512-2250
NPI assigned
Jul 29, 2016
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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 22004442A IN Primary

Addresses

Primary practice location

9240 Greenthread LN
Zionsville, IN 46077

Mailing address

9240 Greenthread LN
Zionsville, IN 46077
Phone (317) 833-9974

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202001110 IN Practitioner - Qualified Speech Language Pathologist 5597048371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Wellness Team LLCGroup PAC ID 5890142145, 41 clinicians

Practice addresses (Care Compare)

11011 Village Square LN
Fishers, IN 46038-4559
Phone (866) 360-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
My Wellness Team LLC Speech-Language Pathologist CurrentSince Jan 6, 2025 Accepting new patients
Adult Speech Pathology of Indiana Speech-Language Pathologist CurrentSince Apr 1, 2024 Accepting new patients

Locations

4411 Park Place Dr
Fort Wayne, IN 46845
Phone (260) 205-8451

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": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1447703020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 GREENTHREAD LN",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "46077",
            "telephone_number": "317-833-9974",
            "fax_number": "866-512-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 GREENTHREAD LN",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "46077",
            "telephone_number": "317-833-9974",
            "fax_number": "866-512-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "MARIANNE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004442A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.