Active NPI
Jessica Sofranko Kisenwether, PHD
- Speech-Language Pathologist
- Albany, NY
National Provider Identifier
1003165044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 022147-1
- Practice address
- 432 Western Ave
Albany, NY 12203-1400 - Phone
- (518) 337-4777
- Fax
- (518) 337-2313
- NPI assigned
- Sep 6, 2012
- 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 | 022147-1 | NY | Primary |
Addresses
Primary practice location
432 Western Ave
Albany, NY 12203-1400
Mailing address
11 Wayland St
Unit 7
Delmar, NY 12054-8218
Phone (518) 337-4777
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022147-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1003165044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 WAYLAND ST",
"address_2": "UNIT 7",
"city": "DELMAR",
"state": "NY",
"postal_code": "120548218",
"telephone_number": "518-337-4777",
"fax_number": "518-337-2313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "432 WESTERN AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "122031400",
"telephone_number": "518-337-4777",
"fax_number": "518-337-2313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISENWETHER",
"first_name": "JESSICA",
"middle_name": "SOFRANKO",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-06",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "022147-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.