Individual provider Active NPI

Michelle Elizabeth Fidler, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Plainville, MA
National Provider Identifier
1982390761
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP100019 Issued in MA
Practice address
30 Man Mar Dr
Plainville, MA 02762-2271
Phone
(508) 695-6848
NPI assigned
Apr 13, 2023
Last updated
Apr 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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 SLP100019 MA Primary

Addresses

Primary practice location

30 Man Mar Dr
Plainville, MA 02762-2271

Mailing address

496 Fruit St
Mansfield, MA 02048-3100
Phone (508) 944-3206

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
SLP100019MAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1982390761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 FRUIT ST",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020483100",
            "telephone_number": "508-944-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAN MAR DR",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027622271",
            "telephone_number": "508-695-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDLER",
        "first_name": "MICHELLE",
        "middle_name": "ELIZABETH",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "SLP100019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.