Active NPI
Demetra Kontos
- Speech-Language Pathologist
- Beavercreek, OH
National Provider Identifier
1497348338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.14708
- Practice address
- 3817 Colonel Glenn Hwy
Beavercreek, OH 45324-2268 - Phone
- (937) 427-9200
- NPI assigned
- Feb 11, 2021
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | COND.20201604-SP | OH | |
| Speech-Language Pathologist | 235Z00000X | SP.14708 | OH | Primary |
Addresses
Primary practice location
3817 Colonel Glenn Hwy
Beavercreek, OH 45324-2268
Mailing address
7591 Tylers Place Blvd
West Chester, OH 45069-6308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0406425 | Medicaid | OH |
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 |
|---|---|---|---|
| COND.20201604-SP | OH | MD | Speech-Language Pathologist |
| SP.14708 | OH | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abc Pediatric Therapy LLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- West Chester, OH
- NPI 1134152861
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1497348338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7591 TYLERS PLACE BLVD",
"city": "WEST CHESTER",
"state": "OH",
"postal_code": "450696308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3817 COLONEL GLENN HWY",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "453242268",
"telephone_number": "937-427-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONTOS",
"first_name": "DEMETRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-11",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "COND.20201604-SP",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.14708",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0406425",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.