Nicole Watt

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00563600 Issued in NJ

Practice address

79 Shady Nook Dr
Toms River, NJ 08755-5127

Phone

(732) 857-4473

NPI assigned

Jan 11, 2017

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

Enrolled in NJ

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Shore Therapy Services LLC

  • Speech-Language Pathologist
  • Toms River, NJ
  • NPI 1790219392
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1245776483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SHADY NOOK DR",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555127",
            "telephone_number": "732-857-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SHADY NOOK DR",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555127",
            "telephone_number": "732-857-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00563600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Washington, CRNA
• Corey Joseph Wasser, DO
• Eric Jonathan Wasserman, MD, FACEP, DABOM
• Water Street Physicians
• Water Street Physicians LLC
• Waves of Transformation Wellness Center Inc
• Bernard R Wayman, M.D.
• We Care Autism Services
• Daniel Weber, PT
• Stephanie Wechsler, APN

• Speech-Language Pathologist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.