Individual provider Active NPI

Jill Stacy Leicher-Kramer, CCC/SLP, TSHH

  • Speech-Language Pathologist
  • Forest Hills, NY
National Provider Identifier
1114204583
Registry record updated Nov 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
008829-1 Issued in NY
Practice address
7025 Yellowstone Blvd
Apt 4M
Forest Hills, NY 11375-3164
Phone
(718) 459-7545
NPI assigned
Nov 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2011

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 008829-1 NY Primary

Addresses

Primary practice location

7025 Yellowstone Blvd
Apt 4M
Forest Hills, NY 11375-3164

Mailing address

7025 Yellowstone Blvd
Apt 4M
Forest Hills, NY 11375-3164
Phone (718) 459-7545

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

LicenseStateTypeSpecialty
008829-1NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1321056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321056000000",
    "number": "1114204583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 YELLOWSTONE BLVD",
            "address_2": "APT 4M",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753164",
            "telephone_number": "718-459-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 YELLOWSTONE BLVD",
            "address_2": "APT 4M",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753164",
            "telephone_number": "718-459-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHER-KRAMER",
        "first_name": "JILL",
        "middle_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "CCC/SLP, TSHH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-12",
        "last_updated": "2011-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008829-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2011; 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.