Individual provider Active NPI

Ann Waldmann, CCC-SLP

  • Speech-Language Pathologist
  • Johnson City, NY
National Provider Identifier
1205170529
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL005475L Issued in PA
Practice address
218 Burbank Ave
Johnson City, NY 13790-3003
Phone
(607) 765-3979
NPI assigned
Nov 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL005475L PA Primary
Speech-Language Pathologist 235Z00000X 008538-1 NY

Addresses

Primary practice location

218 Burbank Ave
Johnson City, NY 13790-3003

Mailing address

218 Burbank Ave
Johnson City, NY 13790-3003
Phone (607) 765-3979

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
008538-1NYMDMassage Therapist
SL005475LPAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1205170529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 BURBANK AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137903003",
            "telephone_number": "607-765-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 BURBANK AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137903003",
            "telephone_number": "607-765-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMANN",
        "first_name": "ANN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL005475L",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008538-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.