Courtney Provost, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

30 Wilson Rd
Williamsville, NY 14221-7026

Phone

(716) 856-4201

NPI assigned

May 7, 2021

Last updated

Jan 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspire of Western New York IncGroup PAC ID 6507759230, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aspire of Western New York Inc.

  • Developmental Disabilities Clinic/Center
  • Cheektowaga, NY
  • NPI 1346337011
  Medicare reassignment Care Compare group NPD
• People Inc.

  • Clinic/Center
  • Buffalo, NY
  • NPI 1497351787
  NPD

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1255915070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 HERTEL AVE STE 101",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071906",
            "telephone_number": "716-566-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WILSON RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217026",
            "telephone_number": "716-856-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "COURTNEY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06435267",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07014708",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Proctor, MD
• Cassandra Prong, ANP-BC
• Proscan Radiology Buffalo, PLLC
• Vincent Prospero, M.S., P.T.
• Emily Provencher, RN
• Karin Andrea Provost, D.O., PHD
• Megan K Prusak, FNP
• Monica Prybylski, ANP
• Emily Przybyl, PA
• Sara Przybyl, LPN

• Speech-Language Pathologist in Williamsville, NY
• Providers in Williamsville, 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 Jan 2, 2024; 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.