Individual provider Active NPI

Lauren Brooke Wiesman, MA, CF-SLP

  • Speech-Language Pathologist
  • Columbus, OH
National Provider Identifier
1457137366
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20232477 Issued in OH
Practice address
1590 Alpine Dr
Columbus, OH 43229-2198
Phone
(614) 365-5359
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 20232477 OH Primary

Addresses

Primary practice location

1590 Alpine Dr
Columbus, OH 43229-2198

Mailing address

736 Civitas Ave Apt 303
Columbus, OH 43215-1990
Phone (513) 382-3654

Other practice location 1

3940 Karl Rd
Columbus, OH 43224-2125
Phone (614) 365-8129

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
20232477OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1457137366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CIVITAS AVE APT 303",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151990",
            "telephone_number": "513-382-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 ALPINE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292198",
            "telephone_number": "614-365-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3940 Karl Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432242125",
            "country_code": "US",
            "telephone_number": "614-365-8129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESMAN",
        "first_name": "LAUREN",
        "middle_name": "BROOKE",
        "credential": "MA, CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "20232477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.