Active NPI
Anne Mendelson Mirman-Tyser, SLP
- Speech-Language Pathologist
- Columbus, OH
National Provider Identifier
1629275185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP1464
- Practice address
- 5500 E Broad St
Columbus, OH 43213-1476 - Phone
- (614) 575-9003
- Fax
- (614) 575-9101
- NPI assigned
- Jun 28, 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 | SP1464 | OH | Primary |
Addresses
Primary practice location
5500 E Broad St
Columbus, OH 43213-1476
Mailing address
6283 Rutherford PL
Columbus, OH 43213-3439
Phone (614) 866-6654
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0845063 | 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 |
|---|---|---|---|
| SP1464 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629275185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6283 RUTHERFORD PL",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432133439",
"telephone_number": "614-866-6654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 E BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432131476",
"telephone_number": "614-575-9003",
"fax_number": "614-575-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRMAN-TYSER",
"first_name": "ANNE",
"middle_name": "MENDELSON",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP1464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0845063",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.