Charlotta Noelle Nutley-Phillips, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

654 Broadway #2F
654 Broadway
New York, NY 10012

Phone

(917) 696-2049

NPI assigned

Oct 17, 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

Other names 1

• Charlotta Noelle Nutley-Phillips Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1295246361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 BROADWAY APT 2F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122328",
            "telephone_number": "646-964-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 BROADWAY #2F",
            "address_2": "654 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10012",
            "telephone_number": "917-696-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTLEY-PHILLIPS",
        "first_name": "CHARLOTTA",
        "middle_name": "NOELLE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLOTTA",
            "last_name": "NUTLEY-PHILLIPS",
            "middle_name": "NOELLE",
            "credential": "CHARLOTTA PHILLIPS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in New York, NY
• Providers in New York, 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 Oct 17, 2017; 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.