Active NPI
Claudia Dirksen
- Speech-Language Pathologist
- Muncie, IN
National Provider Identifier
1447962600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 16004389A
- Practice address
- 12200 S County Road 300 W
Muncie, IN 47302-9468 - Phone
- (765) 644-0500
- NPI assigned
- Dec 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Speech-Language Pathologist | 235Z00000X | 16004389A | IN | Primary |
Addresses
Primary practice location
12200 S County Road 300 W
Muncie, IN 47302-9468
Mailing address
12200 S County Road 300 W
Muncie, IN 47302-9468
Phone (765) 644-0500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16004389A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1447962600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12200 S COUNTY ROAD 300 W",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473029468",
"telephone_number": "765-644-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12200 S COUNTY ROAD 300 W",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473029468",
"telephone_number": "765-644-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIRKSEN",
"first_name": "CLAUDIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-20",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "16004389A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.