Individual provider Active NPI

Pamela Leffers

  • Speech-Language Pathologist
  • Fort Wayne, IN
National Provider Identifier
1902205545
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
46002660A Issued in IN
Practice address
4935 Hillegas Rd
Fort Wayne, IN 46818-1934
Phone
(260) 338-1241
Fax
(260) 338-1231
NPI assigned
Aug 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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 46002660A IN Primary

Addresses

Primary practice location

4935 Hillegas Rd
Fort Wayne, IN 46818-1934

Mailing address

11026 Rivendell CV
Roanoke, IN 46783-8918
Phone (260) 385-0448

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
46002660AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1902205545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11026 RIVENDELL CV",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467838918",
            "telephone_number": "260-385-0448",
            "fax_number": "260-338-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 HILLEGAS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468181934",
            "telephone_number": "260-338-1241",
            "fax_number": "260-338-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFFERS",
        "first_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46002660A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.