Active NPI
Beatrice Monette Fortson, SLP
- Speech-Language Pathologist
- Tonawanda, NY
National Provider Identifier
1104056795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 015190
- Practice address
- 2545 Sheridan Dr
Tonawanda, NY 14150-9478 - Phone
- (716) 833-4884
- NPI assigned
- Jul 17, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 015190 | NY | Primary |
Addresses
Primary practice location
2545 Sheridan Dr
Tonawanda, NY 14150-9478
Mailing address
94 Aegean Avenue
Amherst, NY 14228
Phone (716) 525-1439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015190 | Other | NY | NEW YORK STATE LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247788800000",
"number": "1104056795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 AEGEAN AVENUE",
"city": "AMHERST",
"state": "NY",
"postal_code": "14228",
"telephone_number": "716-525-1439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2545 SHERIDAN DR",
"city": "TONAWANDA",
"state": "NY",
"postal_code": "141509478",
"telephone_number": "716-833-4884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTSON",
"first_name": "BEATRICE",
"middle_name": "MONETTE",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-17",
"last_updated": "2009-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "015190",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE LICENSE",
"identifier": "015190",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tonawanda, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.