Individual provider Active NPI

Melissa Ann Fornoff

  • Speech-Language Pathologist
  • Boerne, TX
National Provider Identifier
1881412013
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
116583 Issued in TX
Practice address
28604 Interstate 10 W
Boerne, TX 78006-9142
Phone
(830) 755-8853
NPI assigned
Sep 27, 2024
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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 116583 TX Primary

Addresses

Primary practice location

28604 Interstate 10 W
Boerne, TX 78006-9142

Mailing address

28614 Bull Ring
Fair Oaks Ranch, TX 78015-4351
Phone (815) 218-6100

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
116583TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Schram-Jamerson, LLC Speech-Language Pathologist PastSince Sep 29, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1881412013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28614 BULL RING",
            "city": "FAIR OAKS RANCH",
            "state": "TX",
            "postal_code": "780154351",
            "telephone_number": "815-218-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28604 INTERSTATE 10 W",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780069142",
            "telephone_number": "830-755-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNOFF",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "116583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.