Individual provider Active NPI

Mikaela Dalbo

  • Speech-Language Pathologist
  • Madison, TN
National Provider Identifier
1982423240
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5779 Issued in TN
Practice address
113 Cumberland Ave Ste 110
Madison, TN 37115-3339
Phone
(615) 596-1830
NPI assigned
Oct 4, 2024
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 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 5779 TN Primary

Addresses

Primary practice location

113 Cumberland Ave Ste 110
Madison, TN 37115-3339

Mailing address

237 Thompson Park Dr
Nashville, TN 37211-2686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251014003286 TN Practitioner - Qualified Speech Language Pathologist 2860989738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

113 Cumberland Ave
Suite 110
Madison, TN 37115-3329

237 Thompson Park Dr
Nashville, TN 37211-2686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9407TNMDPharmacist
5779TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ellenbecker and Borsellino PLLC Multi-Specialty CurrentSince Oct 1, 2025 Accepting new patients

Locations

113 Cumberland Ave
Ste 110
Madison, TN 37115
Phone (615) 596-1830

Organizations & group practices 1

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": "1728000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1982423240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 THOMPSON PARK DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372112686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CUMBERLAND AVE STE 110",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371153339",
            "telephone_number": "615-596-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALBO",
        "first_name": "MIKAELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "5779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.