Nicole Rose Immediato, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

O1-0001611 Issued in DE

Practice address

5147 W Woodmill Dr Ste 21
Wilmington, DE 19808-4067

Phone

(302) 999-0702

NPI assigned

Sep 6, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Speech Clinic, Inc

  • Hearing and Speech Clinic/Center
  • Wilmington, DE
  • NPI 1316655855
  Medicare reassignment NPD

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1013793918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 STONEWOLD WAY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198072568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5147 W WOODMILL DR STE 21",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084067",
            "telephone_number": "302-999-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMEDIATO",
        "first_name": "NICOLE",
        "middle_name": "ROSE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "DE",
            "license": "O1-0001611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolomi T Ikomi, M.D
• Marta D. Illueca, M.D.
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• Paul M. Imber, D.O.
• Immanuel Immanuel, PMHNP-BC
• Michelle Imperiale
• Implied Human Dynamics Personal Care Home (Mary Jane Seacole)
• In Care of Alice & Associates
• In Vision Eye Care, Inc. (Eyeworks Vision Centers)
• Fabio A. Incollingo, CRNA

• Speech-Language Pathologist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Speech-Language Pathologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.