Audrey Maccomer, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-9841 Issued in OH

Practice address

5603 Indianola Ave
Worthington, OH 43085

Phone

(614) 296-4431

NPI assigned

Feb 16, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1598062291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E NORTH BROADWAY ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144114",
            "telephone_number": "614-261-5437",
            "fax_number": "614-263-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 INDIANOLA AVE",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "43085",
            "telephone_number": "614-296-4431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 E North Broadway St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432144114",
            "country_code": "US",
            "telephone_number": "614-261-5437",
            "fax_number": "614-263-5445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACCOMER",
        "first_name": "AUDREY",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-9841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Lynch
• Samantha Lyon, DPT
• Daniel Richard Lytle, M.S.W., L.I.S.W.
• Jonathan Jay Lytle, O.D.
• Christopher Mark Mabry
• Adrienn Dagmar Macdougall
• Alba Macharrie
• Jessica Mackey
• Yolanda Mackey
• Philip Manuel Macy

• Speech-Language Pathologist in Worthington, OH
• Providers in Worthington, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.