Active NPI
Mary Diane Jaeck
- Speech-Language Pathologist
- Tiffin, OH
National Provider Identifier
1851340772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.1395
- Practice address
- 26 High Pointe CT
Tiffin, OH 44883-2650 - Phone
- (419) 447-0398
- NPI assigned
- May 8, 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 | SP.1395 | OH | Primary |
Addresses
Primary practice location
26 High Pointe CT
Tiffin, OH 44883-2650
Mailing address
26 High Pointe CT
Tiffin, OH 44883-2650
Phone (419) 447-0398
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP1395 | Other | OH | OH LICENSE |
| 000000142710 | Other | OH | ANTHEM BLUE CROSS BLUE SH |
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 |
|---|---|---|---|
| SP.1395 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1851340772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 HIGH POINTE CT",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448832650",
"telephone_number": "419-447-0398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 HIGH POINTE CT",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448832650",
"telephone_number": "419-447-0398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAECK",
"first_name": "MARY",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.1395",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH LICENSE",
"identifier": "SP1395",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "000000142710",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.