Individual provider Active NPI

Wendy F. Diebold, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Monroeville, PA
National Provider Identifier
1962533968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
235Z00000X Issued in PA
Practice address
2124 Old Dominion Dr
Monroeville, PA 15146-4818
Phone
(412) 973-7599
Fax
(412) 373-2883
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 235Z00000X PA Primary

Addresses

Primary practice location

2124 Old Dominion Dr
Monroeville, PA 15146-4818

Mailing address

2124 Old Dominion Dr
Monroeville, PA 15146-4818
Phone (412) 973-7599

Other identifiers 2

IdentifierTypeStateIssuer
00519694-02OtherPAASHA LICENSE
SL000085LOtherPAPA. STATE LICENSE

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
235Z00000XPAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962533968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 OLD DOMINION DR",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151464818",
            "telephone_number": "412-973-7599",
            "fax_number": "412-373-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 OLD DOMINION DR",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151464818",
            "telephone_number": "412-973-7599",
            "fax_number": "412-373-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEBOLD",
        "first_name": "WENDY",
        "middle_name": "F.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "235Z00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA LICENSE",
            "identifier": "00519694-02",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA. STATE LICENSE",
            "identifier": "SL000085L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.