Individual provider Active NPI

Elizabeth McIntyre, MS CCC-SLP

  • Speech-Language Pathologist
  • Queensbury, NY
National Provider Identifier
1174833362
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020145 Issued in NY
Practice address
133 Aviation Rd
Queensbury, NY 12804-8206
Phone
(518) 798-0170
Fax
(518) 761-9538
NPI assigned
Oct 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 020145 NY Primary

Addresses

Primary practice location

133 Aviation Rd
Queensbury, NY 12804-8206

Mailing address

133 Aviation Road
Queensbury, NY 12804-8206
Phone (518) 798-0170

Other identifiers 1

IdentifierTypeStateIssuer
00752456MedicaidNY

Other names 1

  • Elizabeth Murphy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000732 NY Practitioner - Qualified Speech Language Pathologist 5092957167 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of the Tri-Counties, Inc. CurrentSince Jun 1, 2009 Accepting new patients

Locations

314 S Manning Blvd
Albany, NY 12208
Phone (518) 437-5528

133 Aviation Rd
Queensbury, NY 12804
Phone (518) 798-0170

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1174833362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 AVIATION ROAD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048206",
            "telephone_number": "518-798-0170",
            "fax_number": "518-761-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 AVIATION RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048206",
            "telephone_number": "518-798-0170",
            "fax_number": "518-761-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "ELIZABETH",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00752456",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MURPHY",
            "credential": "MSCCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.