Active NPI
Alexis Waldron, M.S., CF-SLP
- Speech-Language Pathologist
- Warsaw, IN
National Provider Identifier
1659155315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 46004372A
- Practice address
- 902 Provident Dr Ste C
Warsaw, IN 46580-3379 - Phone
- (574) 376-2316
- NPI assigned
- Aug 23, 2023
- 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 | 46004372A | IN | Primary |
Addresses
Primary practice location
902 Provident Dr Ste C
Warsaw, IN 46580-3379
Mailing address
902 Provident Dr Ste C
Warsaw, IN 46580-3379
Phone (574) 376-2316
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46004372A | IN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joes Kids Inc | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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": "1692748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1659155315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 PROVIDENT DR STE C",
"city": "WARSAW",
"state": "IN",
"postal_code": "465803379",
"telephone_number": "574-376-2316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 PROVIDENT DR STE C",
"city": "WARSAW",
"state": "IN",
"postal_code": "465803379",
"telephone_number": "574-376-2316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRON",
"first_name": "ALEXIS",
"credential": "M.S., CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-23",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "46004372A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.