Active NPI
Ellyse Leopold, MA CCC-SLP
- Speech-Language Pathologist
- Tiffin, OH
National Provider Identifier
1982128757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.11698
- Practice address
- 2550 S State Route 100
Tiffin, OH 44883-9356 - Phone
- (419) 447-7203
- NPI assigned
- Aug 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP.11698 | OH | Primary |
Addresses
Primary practice location
2550 S State Route 100
Tiffin, OH 44883-9356
Mailing address
2913 S Township Road 159
Tiffin, OH 44883-8809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0940576 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP.11698 | OH | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| P T Services Rehabilitation Inc | Past | Accepting new patients | |
| P.T. Services Rehabilitation, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660521600000",
"number": "1982128757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2913 S TOWNSHIP ROAD 159",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448838809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 S STATE ROUTE 100",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448839356",
"telephone_number": "419-447-7203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEOPOLD",
"first_name": "ELLYSE",
"credential": "MA CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-02",
"last_updated": "2022-08-15",
"certification_date": "2022-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.11698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0940576",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.