Active NPI
Bonnie J Salata
- Speech-Language Pathologist
- Boardman, OH
National Provider Identifier
1992969158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP3366
- Practice address
- 6614 Southern Blvd
Boardman, OH 44512-3455 - Phone
- (330) 726-8855
- Fax
- (330) 726-9182
- NPI assigned
- Jul 16, 2008
- 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 | SP3366 | OH | Primary |
Addresses
Primary practice location
6614 Southern Blvd
Boardman, OH 44512-3455
Mailing address
6614 Southern Blvd
Boardman, OH 44512-3455
Phone (330) 726-8855
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11508492 | Other | OH | CAQH |
| 000000175074 | Other | OH | UNISON |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP3366 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216166400000",
"number": "1992969158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6614 SOUTHERN BLVD",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "445123455",
"telephone_number": "330-726-8855",
"fax_number": "330-726-9182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6614 SOUTHERN BLVD",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "445123455",
"telephone_number": "330-726-8855",
"fax_number": "330-726-9182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALATA",
"first_name": "BONNIE",
"middle_name": "J",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-16",
"last_updated": "2008-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP3366",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11508492",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "000000175074",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.