Individual provider Active NPI

Elizabeth Ashley Holley, SLP

  • Speech-Language Pathologist
  • Mason, OH
National Provider Identifier
1710563739
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20201309-SP Issued in OH
Practice address
411 Western Row Rd
Mason, OH 45040-1438
Phone
(513) 398-1486
NPI assigned
Mar 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 20201309-SP OH Primary

Addresses

Primary practice location

411 Western Row Rd
Mason, OH 45040-1438

Mailing address

10501 Landing Way Apt 311
Miamisburg, OH 45342-1187
Phone (740) 645-5637

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL N/A

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

State licenses

LicenseStateTypeSpecialty
20201309-SPOHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1710563739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 LANDING WAY APT 311",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453421187",
            "telephone_number": "740-645-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WESTERN ROW RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401438",
            "telephone_number": "513-398-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "ELIZABETH",
        "middle_name": "ASHLEY",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "20201309-SP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "411 Western Row Rd",
            "city": "Mason",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450401438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.