Active NPI
Maura Ann Blake-Mahon, CCC-SLP
- Speech-Language Pathologist
- Eastlake, OH
National Provider Identifier
1871216598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.14827
- Practice address
- 34050 Glen Dr
Eastlake, OH 44095-2604 - Phone
- (440) 283-4375
- NPI assigned
- Sep 20, 2022
- 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.14827 | OH | Primary |
Addresses
Primary practice location
34050 Glen Dr
Eastlake, OH 44095-2604
Mailing address
26007 Byron Dr
North Olmsted, OH 44070-1913
Phone (440) 829-6356
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.14827 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701302400000",
"number": "1871216598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26007 BYRON DR",
"city": "NORTH OLMSTED",
"state": "OH",
"postal_code": "440701913",
"telephone_number": "440-829-6356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34050 GLEN DR",
"city": "EASTLAKE",
"state": "OH",
"postal_code": "440952604",
"telephone_number": "440-283-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE-MAHON",
"first_name": "MAURA",
"middle_name": "ANN",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-20",
"last_updated": "2023-11-30",
"certification_date": "2023-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.14827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastlake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.