Individual provider Active NPI

Marissa Leigh Hole, MA, CCC-SLP

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1508621707
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2783 Issued in NE
Practice address
425 N 30TH St
Omaha, NE 68131-2100
Phone
(531) 355-5000
NPI assigned
Feb 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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 2783 NE Primary

Addresses

Primary practice location

425 N 30TH St
Omaha, NE 68131-2100

Mailing address

555 N 30TH St
Omaha, NE 68131-2136
Phone (531) 355-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502003208 NE Practitioner - Qualified Speech Language Pathologist 6305286634 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2783NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home CurrentSince Mar 23, 2024 Accepting new patients
ENT Services PC Speech-Language Pathologist Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

14098 Mother Teresa LN
Boys Town, NE 68010

425 N 30th St
Omaha, NE 68131
Phone (402) 452-5000

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

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": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1508621707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312136",
            "telephone_number": "531-355-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312100",
            "telephone_number": "531-355-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLE",
        "first_name": "MARISSA",
        "middle_name": "LEIGH",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "2783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.