Nicole Donnelly

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101006661 Issued in MI

Practice address

45 N Whittaker St Ste 204
New Buffalo, MI 49117-1173

Phone

(269) 235-9821

Fax

(269) 359-3735

NPI assigned

Aug 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sunflower Therapy Centers Inc

  • Speech-Language Pathologist
  • Saint Joseph, MI
  • NPI 1952099715
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693699200000",
    "number": "1770915431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MICHIGAN ST",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491171370",
            "telephone_number": "708-921-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N WHITTAKER ST STE 204",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491171173",
            "telephone_number": "269-235-9821",
            "fax_number": "269-359-3735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8583 Tullamore Dr",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604874774",
            "country_code": "US",
            "telephone_number": "708-921-5381",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "New Buffalo",
            "state": "MI",
            "postal_code": "491171370",
            "country_code": "US",
            "telephone_number": "708-921-5381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2023-09-03",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.002629",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22006997A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101006661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Colon
• Amelia Anne Danesi
• David P. Kelsey, M.D. Kelsey Medical Center
• Allison Ann Dent
• Diane Giancaspro LCSW LLC
• DRS Steven and Brenda Smoke OD PC
• Melissa Ann Forker
• Piper Friend
• Ashley Gage, CPHT
• Rebecca Lynn Gardner-Reilly, MPT

• Speech-Language Pathologist in New Buffalo, MI
• Providers in New Buffalo, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.