Active NPI
Kenneth J Sargent, CCC-SLP
- Speech-Language Pathologist
- King Ferry, NY
National Provider Identifier
1285831388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 005172-1
- Practice address
- 8842 Route 90
Mandel Therapy Group
King Ferry, NY 13081 - Phone
- (315) 364-7570
- Fax
- (315) 364-8016
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 005172-1 | NY | Primary |
Addresses
Primary practice location
8842 Route 90
Mandel Therapy Group
King Ferry, NY 13081
Mailing address
43 Melrose Rd
Auburn, NY 13021-9203
Phone (315) 255-6143
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005172-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285831388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 MELROSE RD",
"city": "AUBURN",
"state": "NY",
"postal_code": "130219203",
"telephone_number": "315-255-6143",
"fax_number": "315-364-8016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8842 ROUTE 90",
"address_2": "MANDEL THERAPY GROUP",
"city": "KING FERRY",
"state": "NY",
"postal_code": "13081",
"telephone_number": "315-364-7570",
"fax_number": "315-364-8016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARGENT",
"first_name": "KENNETH",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "005172-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in King Ferry, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.