Individual provider Active NPI

Devin Bobbi-Tracey Custer, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Richmond, ME
National Provider Identifier
1053628768
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1665 Issued in ME
Practice address
28 High Street
Richmond, ME 04357
Phone
(207) 740-2227
NPI assigned
Sep 2, 2010
Last updated
Sep 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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 SP1665 ME Primary

Addresses

Primary practice location

28 High Street
Richmond, ME 04357

Mailing address

37 Nottingham Lane
Litchfield, ME 04350
Phone (207) 740-2227

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP1665MEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1053628768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 NOTTINGHAM LANE",
            "city": "LITCHFIELD",
            "state": "ME",
            "postal_code": "04350",
            "telephone_number": "207-740-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 HIGH STREET",
            "city": "RICHMOND",
            "state": "ME",
            "postal_code": "04357",
            "telephone_number": "207-740-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "DEVIN",
        "middle_name": "BOBBI-TRACEY",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP1665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.