Active NPI
Barbara Edeson Roth, MA, CCC-SLP
- Speech-Language Pathologist
- Greenwich, CT
National Provider Identifier
1245866433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 004069-01
- Practice address
- The Nathaniel Witherell Home
70 Parsonage Road
Greenwich, CT 06830 - Phone
- (203) 618-4200
- NPI assigned
- Mar 19, 2020
- 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 | 004069-01 | NY | Primary |
Addresses
Primary practice location
The Nathaniel Witherell Home
70 Parsonage Road
Greenwich, CT 06830
Mailing address
220 Chestnut St Apt 1C
Port Chester, NY 10573-3140
Phone (914) 565-9677
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004069-01 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1245866433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 CHESTNUT ST APT 1C",
"city": "PORT CHESTER",
"state": "NY",
"postal_code": "105733140",
"telephone_number": "914-565-9677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "THE NATHANIEL WITHERELL HOME",
"address_2": "70 PARSONAGE ROAD",
"city": "GREENWICH",
"state": "CT",
"postal_code": "06830",
"telephone_number": "203-618-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "BARBARA",
"middle_name": "EDESON",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-19",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "004069-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.