Individual provider Active NPI

Jennifer Thomson

  • Speech-Language Pathologist
  • Newark, NY
National Provider Identifier
1023274644
Registry record updated Aug 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
011496-1 Issued in NY
Practice address
848 Peirson Ave
Newark, NY 14513-9762
Phone
(315) 331-2086
NPI assigned
Aug 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2008

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 011496-1 NY Primary

Addresses

Primary practice location

848 Peirson Ave
Newark, NY 14513-9762

Mailing address

848 Peirson Ave
Newark, NY 14513-9762
Phone (315) 331-2086

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
011496-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217721600000",
    "number": "1023274644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 PEIRSON AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145139762",
            "telephone_number": "315-331-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 PEIRSON AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145139762",
            "telephone_number": "315-331-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-03",
        "last_updated": "2008-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011496-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.

Verify at the official NPI Registry.