Individual provider Active NPI

Ivy Ellsworth, MS

  • Speech-Language Pathologist
  • Shaker Heights, OH
National Provider Identifier
1467253096
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.16304 Issued in OH
Practice address
3570 Warrensville Center Rd
Shaker Heights, OH 44122-5288
Phone
(216) 282-1582
NPI assigned
Mar 20, 2025
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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 SP.16304 OH Primary

Addresses

Primary practice location

3570 Warrensville Center Rd
Shaker Heights, OH 44122-5288

Mailing address

306 New St
Fairport Harbor, OH 44077-5529
Phone (440) 523-1842

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 Science

State licenses

LicenseStateTypeSpecialty
SP.16304OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
FM Speech Therapy LLC PastSince Jul 31, 2023 Accepting new patients
FM Speech Therapy LLC PastSince Jul 31, 2023 Accepting new patients

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": "1742428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1467253096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 NEW ST",
            "city": "FAIRPORT HARBOR",
            "state": "OH",
            "postal_code": "440775529",
            "telephone_number": "440-523-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 WARRENSVILLE CENTER RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225288",
            "telephone_number": "216-282-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "IVY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-20",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.16304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; 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.