Individual provider Active NPI

Jacqueline Christine Dolson-Shewchuk, MSLP CCC-SLP

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1003055708
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
015993-1 Issued in NY
Practice address
241 W 72ND St # 2
New York, NY 10023-2703
Phone
(212) 580-1910
Fax
(212) 580-1910
NPI assigned
Feb 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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 015993-1 NY Primary

Addresses

Primary practice location

241 W 72ND St # 2
New York, NY 10023-2703

Mailing address

78 W 85TH St Apt 5D
New York, NY 10024-4568
Phone (212) 595-5352

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

LicenseStateTypeSpecialty
015993-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1003055708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 W 85TH ST APT 5D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244568",
            "telephone_number": "212-595-5352",
            "fax_number": "212-580-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 W 72ND ST # 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232703",
            "telephone_number": "212-580-1910",
            "fax_number": "212-580-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLSON-SHEWCHUK",
        "first_name": "JACQUELINE",
        "middle_name": "CHRISTINE",
        "credential": "MSLP CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015993-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.