Individual provider Active NPI

Dianne M. Crea-Powers, MSCCC-SLP

  • Speech-Language Pathologist
  • Bergen, NY
National Provider Identifier
1164707246
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005750-1 Issued in NY
Practice address
6917 W Bergen Rd
Bergen, NY 14416-9743
Phone
(585) 494-2220
NPI assigned
Oct 20, 2011
Last updated
Nov 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 005750-1 NY Primary

Addresses

Primary practice location

6917 W Bergen Rd
Bergen, NY 14416-9743

Mailing address

6917 W Bergen Rd
Bergen, NY 14416-9743
Phone (585) 494-2220

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
005750-1NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Byron-Bergen Central School District Past Accepting new patients

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": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1164707246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6917 W BERGEN RD",
            "city": "BERGEN",
            "state": "NY",
            "postal_code": "144169743",
            "telephone_number": "585-494-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6917 W BERGEN RD",
            "city": "BERGEN",
            "state": "NY",
            "postal_code": "144169743",
            "telephone_number": "585-494-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREA-POWERS",
        "first_name": "DIANNE",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "MSCCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005750-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bergen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.