Active NPI
Jody G Marshall, SLP
- Speech-Language Pathologist
- Clarence, NY
National Provider Identifier
1205116720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 015200-1
- Practice address
- 5150 Old Goodrich Rd
Clarence, NY 14031-2406 - Phone
- (716) 407-9275
- NPI assigned
- Aug 29, 2011
- Last updated
- Aug 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 015200-1 | NY | Primary |
Addresses
Primary practice location
5150 Old Goodrich Rd
Clarence, NY 14031-2406
Mailing address
900 Bowen Rd
Elma, NY 14059-9544
Phone (716) 652-1865
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
| License | State | Type | Specialty |
|---|---|---|---|
| 015200-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314576000000",
"number": "1205116720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 BOWEN RD",
"city": "ELMA",
"state": "NY",
"postal_code": "140599544",
"telephone_number": "716-652-1865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 OLD GOODRICH RD",
"city": "CLARENCE",
"state": "NY",
"postal_code": "140312406",
"telephone_number": "716-407-9275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "JODY",
"middle_name": "G",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-29",
"last_updated": "2011-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "015200-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarence, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.