Active NPI
Sarah Michelle, SLP
- Speech-Language Pathologist
- Brooktondale, NY
National Provider Identifier
1093962060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 010040-1
- Practice address
- 547 Valley Rd
Brooktondale, NY 14817-9702 - Phone
- (607) 220-7813
- NPI assigned
- Aug 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 010040-1 | NY | Primary |
Addresses
Primary practice location
547 Valley Rd
Brooktondale, NY 14817-9702
Mailing address
547 Valley Rd
Brooktondale, NY 14817-9702
Phone (607) 220-7813
Other names 1
- Sarah Stark
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
| License | State | Type | Specialty |
|---|---|---|---|
| 010040-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390867200000",
"number": "1093962060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "547 VALLEY RD",
"city": "BROOKTONDALE",
"state": "NY",
"postal_code": "148179702",
"telephone_number": "607-220-7813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "547 VALLEY RD",
"city": "BROOKTONDALE",
"state": "NY",
"postal_code": "148179702",
"telephone_number": "607-220-7813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELLE",
"first_name": "SARAH",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-21",
"last_updated": "2014-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "010040-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARAH",
"last_name": "STARK",
"credential": "SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brooktondale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.