Active NPI
Katie J. Telle, M.A.
- Speech-Language Pathologist
- Rochester, NY
National Provider Identifier
1174775308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 018479-1
- Practice address
- 100 Groton Pkwy
Rochester, NY 14623-4540 - Phone
- (585) 359-3710
- NPI assigned
- Oct 21, 2008
- 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 | 018479-1 | NY | Primary |
Addresses
Primary practice location
100 Groton Pkwy
Rochester, NY 14623-4540
Mailing address
100 Groton Pkwy
Rochester, NY 14623-4540
Phone (585) 359-3710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30-0213081 | Other | TAX ID |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018479-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1174775308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 GROTON PKWY",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146234540",
"telephone_number": "585-359-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 GROTON PKWY",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146234540",
"telephone_number": "585-359-3710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLE",
"first_name": "KATIE",
"middle_name": "J.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2010-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "018479-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "30-0213081",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.