Individual provider Active NPI

Lauren Nicole Bostwick, M.S.ED

  • Speech-Language Pathologist
  • Blossvale, NY
National Provider Identifier
1104501543
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
8564 State Route 13
Blossvale, NY 13308-3419
Phone
(315) 245-3412
NPI assigned
Jun 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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 NY Primary

Addresses

Primary practice location

8564 State Route 13
Blossvale, NY 13308-3419

Mailing address

109 Wakefield LN
Ava, NY 13303-1816
Phone (315) 790-0495

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": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1104501543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WAKEFIELD LN",
            "city": "AVA",
            "state": "NY",
            "postal_code": "133031816",
            "telephone_number": "315-790-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8564 STATE ROUTE 13",
            "city": "BLOSSVALE",
            "state": "NY",
            "postal_code": "133083419",
            "telephone_number": "315-245-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTWICK",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "M.S.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blossvale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.