Individual provider Active NPI

Sherry T. Gliesche, MA,MS, CCC/SLP

  • Speech-Language Pathologist
  • Micanopy, FL
National Provider Identifier
1649479601
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 6552 Issued in FL
Practice address
8800 NW 230TH St
Micanopy, FL 32667-7476
Phone
(352) 284-4948
Fax
(352) 466-1045
NPI assigned
Jul 11, 2007
Last updated
Jul 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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 SA 6552 FL Primary

Addresses

Primary practice location

8800 NW 230TH St
Micanopy, FL 32667-7476

Mailing address

PO Box 357742
Gainesville, FL 32635-7742
Phone (352) 284-4948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125001785 FL Practitioner - Qualified Speech Language Pathologist 9638561616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loveland Center IncGroup PAC ID 2163813460, 5 clinicians

Practice addresses (Care Compare)

157 S Havana Rd
Venice, FL 34292-3104
Phone 9414930016320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SA 6552FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Loveland Center, Inc. CurrentSince Jan 31, 2022 Accepting new patients
Loveland Center, Inc. CurrentSince Feb 23, 2025 Accepting new patients

Locations

157 S Havana Rd
Venice, FL 34292
Phone (941) 493-0016

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1649479601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357742",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326357742",
            "telephone_number": "352-284-4948",
            "fax_number": "352-466-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 NW 230TH ST",
            "city": "MICANOPY",
            "state": "FL",
            "postal_code": "326677476",
            "telephone_number": "352-284-4948",
            "fax_number": "352-466-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIESCHE",
        "first_name": "SHERRY",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "credential": "MA,MS, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 6552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Micanopy, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.