Individual provider Active NPI

Sandra Ann Barron-Penke

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1023396090
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012406-1 Issued in NY
Practice address
311 Flower City Park
Rochester, NY 14615-3614
Phone
(585) 254-2080
NPI assigned
Jul 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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 012406-1 NY Primary

Addresses

Primary practice location

311 Flower City Park
Rochester, NY 14615-3614

Mailing address

5 Alton Way
West Henrietta, NY 14586-9673
Phone (585) 359-1981

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
012406-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1023396090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ALTON WAY",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869673",
            "telephone_number": "585-359-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 FLOWER CITY PARK",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146153614",
            "telephone_number": "585-254-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRON-PENKE",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012406-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.