Individual provider Active NPI

Marissa Christine Reed, SLP

  • Speech-Language Pathologist
  • Niles, OH
National Provider Identifier
1972925519
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.11534 Issued in OH
Practice address
918 Youngstown Warren Rd
Niles, OH 44446-4623
Phone
(330) 505-1606
Fax
(330) 505-2621
NPI assigned
Jan 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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.11534 OH Primary

Addresses

Primary practice location

918 Youngstown Warren Rd
Niles, OH 44446-4623

Mailing address

3465 Tod Ave NW
Warren, OH 44485-1362
Phone (330) 675-6980

Other practice location 1

1932 Niles Cortland Rd NE
Warren, OH 44484-1055
Phone (330) 856-1520

Other identifiers 1

IdentifierTypeStateIssuer
0224160MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP.11534OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972925519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 TOD AVE NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444851362",
            "telephone_number": "330-675-6980",
            "fax_number": "330-675-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 YOUNGSTOWN WARREN RD",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464623",
            "telephone_number": "330-505-1606",
            "fax_number": "330-505-2621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1932 Niles Cortland Rd NE",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444841055",
            "country_code": "US",
            "telephone_number": "330-856-1520",
            "fax_number": "330-856-7342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED",
        "first_name": "MARISSA",
        "middle_name": "CHRISTINE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0224160",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.