Active NPI
Jill J Bero, CCC-SLP
- Speech-Language Pathologist
- Watertown, NY
National Provider Identifier
1306154000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 007989-1
- Practice address
- 1351 Washington St
Watertown, NY 13601-4531 - Phone
- (315) 785-3728
- NPI assigned
- Sep 16, 2010
- 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 | 007989-1 | NY | Primary |
Addresses
Primary practice location
1351 Washington St
Watertown, NY 13601-4531
Mailing address
49 E Church St
Adams, NY 13605-1102
Phone (315) 232-2291
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 |
|---|---|---|---|
| 007989-1 | NY | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284595200000",
"number": "1306154000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 E CHURCH ST",
"city": "ADAMS",
"state": "NY",
"postal_code": "136051102",
"telephone_number": "315-232-2291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 WASHINGTON ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136014531",
"telephone_number": "315-785-3728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERO",
"first_name": "JILL",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-16",
"last_updated": "2010-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "007989-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.