Individual provider Active NPI

Anna Marie Nuwagaba, SLP

  • Speech-Language Pathologist
  • Cheshire, CT
National Provider Identifier
1164244802
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7641 Issued in CT
Practice address
382 S Main St
Cheshire, CT 06410-1379
Phone
(203) 250-9663
Fax
(203) 699-9641
NPI assigned
Oct 24, 2024
Last updated
Oct 24, 2024By the provider in NPPES
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 7641 CT Primary

Addresses

Primary practice location

382 S Main St
Cheshire, CT 06410-1379

Mailing address

382 S Main St
Cheshire, CT 06410-1379
Phone (203) 250-9663

Other names 1

  • Anna Marie Ciccarello Former name

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
7641CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cheshire Fitness Zone, LLC Speech-Language Pathologist CurrentSince Oct 27, 2024 Accepting new patients

Locations

10 George Ave
Cheshire, CT 06410
Phone (203) 271-0659

382 S Main St
Cheshire, CT 06410

262 Main St
Oakville, CT 06779
Phone (203) 706-0479

157 Litchfield St
Torrington, CT 06790
Phone (860) 489-1328

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1164244802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101379",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101379",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUWAGABA",
        "first_name": "ANNA MARIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "7641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA MARIE",
            "last_name": "CICCARELLO",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.