Individual provider Active NPI

Wendy Leborgne, PH.D. CCC-SLP

  • Speech-Language Pathologist
  • Dayton, OH
National Provider Identifier
1831573401
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP5881 Issued in OH
Practice address
1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone
(937) 496-2622
NPI assigned
Jul 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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 SP5881 OH Primary

Addresses

Primary practice location

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684

Mailing address

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone (937) 496-2622

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SP5881OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1831573401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBORGNE",
        "first_name": "WENDY",
        "credential": "PH.D. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP5881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.