Individual provider Active NPI

Derrick Robinson, MA SLP CCC

  • Speech-Language Pathologist
  • Cincinnati, OH
National Provider Identifier
1649657339
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.11174 Issued in OH
Practice address
6809 Main St # 1268
Cincinnati, OH 45244-3470
Phone
(513) 410-5582
Fax
(513) 270-2682
NPI assigned
May 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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 SP.11174 OH Primary

Addresses

Primary practice location

6809 Main St # 1268
Cincinnati, OH 45244-3470

Mailing address

6809 Main St # 1268
Cincinnati, OH 45244-3470
Phone (513) 410-5582

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)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1649657339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 MAIN ST # 1268",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452443470",
            "telephone_number": "513-410-5582",
            "fax_number": "513-270-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 MAIN ST # 1268",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452443470",
            "telephone_number": "513-410-5582",
            "fax_number": "513-270-2682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "DERRICK",
        "name_prefix": "Mr.",
        "credential": "MA SLP CCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-01",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.