Individual provider Active NPI

Sarah June Watson

  • Speech-Language Pathologist
  • Fulton, NY
National Provider Identifier
1043705510
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
029335 Issued in NY
Practice address
129 Curtis St
Fulton, NY 13069-4967
Phone
(315) 593-5500
NPI assigned
Jun 27, 2018
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 029335 NY Primary

Addresses

Primary practice location

129 Curtis St
Fulton, NY 13069-4967

Mailing address

8821 New Country Dr Apt 7
Cicero, NY 13039-8633
Phone (518) 817-7467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200709002816 NY Practitioner - Qualified Speech Language Pathologist 8123441151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029335NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cani PT OT SLP & Psychology PLLC CurrentSince Jun 29, 2020 Accepting new patients

Locations

216 County Route 64
Mexico, NY 13114
Phone (315) 963-0864

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1043705510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8821 NEW COUNTRY DR APT 7",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130398633",
            "telephone_number": "518-817-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 CURTIS ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130694967",
            "telephone_number": "315-593-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SARAH",
        "middle_name": "JUNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.