Nisanth Panicker, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00004115 Issued in WA

Practice address

920 12TH Ave SE
Puyallup, WA 98372-4920

Phone

(253) 841-3422

Fax

(206) 445-4043

NPI assigned

Jun 5, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehab SLP FL LLCGroup PAC ID 9638577125, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Fox Rehab SLP FL LLC

  • Speech-Language Pathologist
  • Orlando, FL
  • NPI 1912577214
  Medicare reassignment Care Compare group
• QRM Plus Florida SLP LLC

  • Speech-Language Pathologist
  • Clearwater, FL
  • NPI 1184377566
  Medicare reassignment NPD

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1790944684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 12TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724920",
            "telephone_number": "253-841-3422",
            "fax_number": "206-445-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 12TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724920",
            "telephone_number": "253-841-3422",
            "fax_number": "206-445-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICKER",
        "first_name": "NISANTH",
        "name_prefix": "Mr.",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab SLP FL LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "8450 Lockwood Ridge Rd",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342432920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab SLP FL LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "3801 Bee Ridge Rd Ste 5",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342331157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab SLP FL LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "3626 Tamiami Trl",
            "city": "Port Charlotte",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339528243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab SLP FL LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "3882 Central Sarasota Pkwy",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342383046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Sarlund-Heinrich, P.S.
• Job Pan, PHARMD
• July Pan
• Shirjana Pandey
• Skyler Pang, DMD
• Cassandra Papademetriou, PT
• Jeremy Thomas Pape
• Traci Marie Parham, PT
• Gena Paris
• Bryana Park, LMT

• Speech-Language Pathologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.