NPIMap

Individual provider Active NPI

Lewis Ardin Vanausdle, MA, CCC-SLP

  • Speech-Language Pathologist
  • Middletown, OH
National Provider Identifier
1679973457
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.10509 Issued in OH
Practice address
7 S Marshall Rd
Middletown, OH 45044-5375
Phone
(513) 420-9767
NPI assigned
Aug 28, 2014
Last updated
Aug 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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.10509 OH Primary

Addresses

Primary practice location

7 S Marshall Rd
Middletown, OH 45044-5375

Mailing address

4580 Helmsdale CT
Batavia, OH 45103-4000
Phone (330) 907-9258

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 Arts

State licenses

LicenseStateTypeSpecialty
SP.10509OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Academy Management 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, 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": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1679973457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 HELMSDALE CT",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451034000",
            "telephone_number": "330-907-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S MARSHALL RD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450445375",
            "telephone_number": "513-420-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANAUSDLE",
        "first_name": "LEWIS",
        "middle_name": "ARDIN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.10509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.