Individual provider Active NPI

Olivia R Rogers

  • Speech-Language Pathologist
  • Newton, MA
National Provider Identifier
1265189492
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
78390-SP-SL Issued in MA
Practice address
55 Chapel St Ste 202
Newton, MA 02458-1072
Phone
(617) 658-9800
NPI assigned
Mar 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 78390-SP-SL MA Primary

Addresses

Primary practice location

55 Chapel St Ste 202
Newton, MA 02458-1072

Mailing address

83 Walnut St Apt 1
Dorchester, MA 02122-3618
Phone (339) 933-3813

Other practice location 1

19 Muzzey St
Lexington, MA 02421-5256
Phone (978) 237-4937 ext. 100

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
78390-SP-SLMAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1265189492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 WALNUT ST APT 1",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223618",
            "telephone_number": "339-933-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CHAPEL ST STE 202",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581072",
            "telephone_number": "617-658-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Muzzey St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "MA",
            "postal_code": "024215256",
            "country_code": "US",
            "telephone_number": "978-237-4937 x100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "OLIVIA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "78390-SP-SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.