Individual provider Active NPI

Lydia Elaine Engle, CCC-SLP

  • Speech-Language Pathologist
  • Springfield, OH
National Provider Identifier
1972367498
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.06075 Issued in OH
Practice address
2900 N Bechtle Ave
Springfield, OH 45504-1599
Phone
(937) 342-1460
NPI assigned
Feb 7, 2024
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 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 SP.06075 OH Primary

Addresses

Primary practice location

2900 N Bechtle Ave
Springfield, OH 45504-1599

Mailing address

812 Cleary Dr
Fairborn, OH 45324-4498
Phone (937) 974-4498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240304003486 OH Practitioner - Qualified Speech Language Pathologist 9335584002 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Feb 1, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

2701 Chestnut Station Ct
Louisville, KY 40299
Phone (502) 964-5359

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

60 Paceline Cir
Xenia, OH 45385
Phone (937) 372-1530

Organizations & group practices 2

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1972367498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 CLEARY DR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453244498",
            "telephone_number": "937-974-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N BECHTLE AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455041599",
            "telephone_number": "937-342-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLE",
        "first_name": "LYDIA",
        "middle_name": "ELAINE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.06075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.