Individual provider Active NPI

Melanie J Jordan, MASTER OF ARTS

  • Speech-Language Pathologist
  • Youngstown, OH
National Provider Identifier
1679862924
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-2430 Issued in OH
Practice address
211 Redondo Rd
Youngstown, OH 44504-1805
Phone
(330) 744-2000
NPI assigned
Apr 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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-2430 OH Primary

Addresses

Primary practice location

211 Redondo Rd
Youngstown, OH 44504-1805

Mailing address

430 Bonnie Brae Rd
Vienna, OH 44473-9675
Phone (330) 856-4307

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

State licenses

LicenseStateTypeSpecialty
SP-2430OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1679862924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BONNIE BRAE RD",
            "city": "VIENNA",
            "state": "OH",
            "postal_code": "444739675",
            "telephone_number": "330-856-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 REDONDO RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041805",
            "telephone_number": "330-744-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MELANIE",
        "middle_name": "J",
        "credential": "MASTER OF ARTS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-2430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.