Individual provider Active NPI

Nicole Allen, CCC-SLP

  • Speech-Language Pathologist
  • Greenwood, IN
National Provider Identifier
1871867622
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22005496A Issued in IN
Practice address
21 S Park Blvd
Suite 21
Greenwood, IN 46143-8838
Phone
(317) 449-2104
Fax
(765) 450-6664
NPI assigned
Feb 25, 2012
Last updated
Dec 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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 22005496A IN Primary

Addresses

Primary practice location

21 S Park Blvd
Suite 21
Greenwood, IN 46143-8838

Mailing address

700 E. Firmin Street
Suite 209
Kokomo, IN 46902-2375
Phone (765) 454-9748

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

LicenseStateTypeSpecialty
22005496AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1330128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1871867622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E. FIRMIN STREET",
            "address_2": "SUITE 209",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022375",
            "telephone_number": "765-454-9748",
            "fax_number": "765-450-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 S PARK BLVD",
            "address_2": "SUITE 21",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438838",
            "telephone_number": "317-449-2104",
            "fax_number": "765-450-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "NICOLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-25",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005496A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.