Individual provider Active NPI

Caitlin Fattore

  • Speech-Language Pathologist
  • Connersville, IN
National Provider Identifier
1508248683
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2015311 Issued in OH
Practice address
1029 E 5TH St
Connersville, IN 47331-3301
Phone
(765) 825-0543
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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 2015311 OH Primary

Addresses

Primary practice location

1029 E 5TH St
Connersville, IN 47331-3301

Mailing address

1029 E 5TH St
Connersville, IN 47331-3301
Phone (765) 825-0543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY, KY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230130001984 OH Practitioner - Qualified Speech Language Pathologist 7810372711 Reassigns benefits to 2 organizations
I20230327000681 NY Practitioner - Qualified Speech Language Pathologist 7810372711 Reassigns benefits to 1 organization
I20250211002378 KY Practitioner - Qualified Speech Language Pathologist 7810372711 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015311OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theradynamics Rehab. PT, OT & SLP, PLLC Speech-Language Pathologist CurrentSince Jan 1, 2023 Accepting new patients
Seniority Wellness & Consulting LLC CurrentSince Jun 11, 2023 Accepting new patients

Locations

182 Barnwood Dr
Edgewood, KY 41017
Phone (513) 799-8263

280 W 231st St
Bronx, NY 10463
Phone (718) 548-1212

18716 Hillside Ave
Jamaica, NY 11432
Phone (718) 206-1288

800 E Ross Ave
Cincinnati, OH 45217
Phone (513) 848-3215

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1508248683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 E 5TH ST",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473313301",
            "telephone_number": "765-825-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 E 5TH ST",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473313301",
            "telephone_number": "765-825-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTORE",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "2015311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.