Active NPI
Ann Driscoll Elliott
- Speech-Language Pathologist
- East Syracuse, NY
National Provider Identifier
1134415441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 002390-1
- Practice address
- 303 Roby Ave.
Ocm Boces Children'S Village @ Park Hill School
East Syracuse, NY 13057 - Phone
- (315) 434-3830
- NPI assigned
- Jun 24, 2011
- 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 | 002390-1 | NY | Primary |
Addresses
Primary practice location
303 Roby Ave.
Ocm Boces Children'S Village @ Park Hill School
East Syracuse, NY 13057
Mailing address
303 Roby Ave.
Ocm Boces Children'S Village @ Park Hill School
East Syracuse, NY 13057
Phone (315) 434-3830
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002390-1 | Other | NY | NYS LICENSE SPEECH PATHOLOGY |
| 00687632 | Other | NY | AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION CCC |
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 |
|---|---|---|---|
| 002390-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308873600000",
"number": "1134415441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 ROBY AVE.",
"address_2": "OCM BOCES CHILDREN'S VILLAGE @ PARK HILL SCHOOL",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "13057",
"telephone_number": "315-434-3830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 ROBY AVE.",
"address_2": "OCM BOCES CHILDREN'S VILLAGE @ PARK HILL SCHOOL",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "13057",
"telephone_number": "315-434-3830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "ANN",
"middle_name": "DRISCOLL",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-24",
"last_updated": "2011-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "002390-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS LICENSE SPEECH PATHOLOGY",
"identifier": "002390-1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION CCC",
"identifier": "00687632",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.