Active NPI
Mary J Gillan, MA, CCC-SLP
- Speech-Language Pathologist
- Mansfield, OH
National Provider Identifier
1467649608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP8566
- Practice address
- 335 Glessner Ave
Mansfield, OH 44903-2269 - Phone
- (419) 526-8290
- Fax
- (419) 520-2878
- NPI assigned
- Oct 2, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP8566 | OH | Primary |
Addresses
Primary practice location
335 Glessner Ave
Mansfield, OH 44903-2269
Mailing address
3474 Mill Run Rd
Lexington, OH 44904-9734
Phone (419) 884-1058
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP8566 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1467649608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3474 MILL RUN RD",
"city": "LEXINGTON",
"state": "OH",
"postal_code": "449049734",
"telephone_number": "419-884-1058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 GLESSNER AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449032269",
"telephone_number": "419-526-8290",
"fax_number": "419-520-2878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLAN",
"first_name": "MARY",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-02",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP8566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.