Active NPI
Leta Donica, SLP
- Speech-Language Pathologist
- Fishers, IN
National Provider Identifier
1457657504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22005202A
- Practice address
- 10165 Bootham Close
Fishers, IN 46038-5773 - Phone
- (317) 695-7787
- NPI assigned
- Feb 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22005202A | IN | Primary |
Addresses
Primary practice location
10165 Bootham Close
Fishers, IN 46038-5773
Mailing address
10165 Bootham Close
Fishers, IN 46038-5773
Phone (317) 695-7787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22005202A | Other | IN | IPLA |
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 |
|---|---|---|---|
| 22005202A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297123200000",
"number": "1457657504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10165 BOOTHAM CLOSE",
"city": "FISHERS",
"state": "IN",
"postal_code": "460385773",
"telephone_number": "317-695-7787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10165 BOOTHAM CLOSE",
"city": "FISHERS",
"state": "IN",
"postal_code": "460385773",
"telephone_number": "317-695-7787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONICA",
"first_name": "LETA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-08",
"last_updated": "2011-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22005202A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IPLA",
"identifier": "22005202A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.