Active NPI
Patricia Blakely
- Speech-Language Pathologist
- Thornville, OH
National Provider Identifier
1760593289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2255
- Practice address
- 8745 Blackbird LN
Thornville, OH 43076-9515 - Phone
- (740) 246-5483
- Fax
- (740) 246-6480
- NPI assigned
- Aug 31, 2006
- 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 | 2255 | OH | Primary |
Addresses
Primary practice location
8745 Blackbird LN
Thornville, OH 43076-9515
Mailing address
1025 Camden Dr
Newark, OH 43055-1574
Phone (740) 348-0085
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2255 | OH | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Terra Health Inc. | Past | Accepting new patients | |
| Terra Health, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rehabilitation Clinic/Center
- Thornville, OH
- NPI 1053382325
-
- Physical Therapist
- Thornville, OH
- NPI 1649293770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760593289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 CAMDEN DR",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551574",
"telephone_number": "740-348-0085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8745 BLACKBIRD LN",
"city": "THORNVILLE",
"state": "OH",
"postal_code": "430769515",
"telephone_number": "740-246-5483",
"fax_number": "740-246-6480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKELY",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "2255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.