Ashley M Fuller, SPEECH PATHOLIGIST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

021178-1 Issued in NY

Practice address

456 Broad St
Waverly, NY 14892-1445

Phone

(607) 948-4047

Fax

(607) 565-2200

NPI assigned

Sep 28, 2011

Last updated

Sep 28, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1184907990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 BROAD ST",
            "city": "WAVERLY",
            "state": "NY",
            "postal_code": "148921445",
            "telephone_number": "607-948-4047",
            "fax_number": "607-565-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 BROAD ST",
            "city": "WAVERLY",
            "state": "NY",
            "postal_code": "148921445",
            "telephone_number": "607-948-4047",
            "fax_number": "607-565-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ASHLEY",
        "middle_name": "M",
        "credential": "SPEECH PATHOLIGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "021178-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Waverly, NY
• Providers in Waverly, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.