Individual provider Active NPI

Bethany Cooper Watt, M.S.

  • Speech-Language Pathologist
  • Lexington, KY
National Provider Identifier
1346398799
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2425 Issued in KY
Practice address
2412 Greatstone PT
Lexington, KY 40504-3274
Phone
(859) 224-4081
Fax
(859) 224-4082
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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 2425 KY Primary

Addresses

Primary practice location

2412 Greatstone PT
Lexington, KY 40504-3274

Mailing address

2412 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 224-4081

Other identifiers 1

IdentifierTypeStateIssuer
7100338720MedicaidKY

Other names 1

  • Bethany Anne Cooper Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011000251 KY Practitioner - Qualified Speech Language Pathologist 7315479615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2425KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Horn and Associates in Rehabilitation PLLC Speech-Language Pathologist CurrentSince May 1, 2024 Accepting new patients

Locations

4127 Todds Rd
Lexington, KY 40509
Phone (859) 224-4081

2412 Greatstone Pt
Lexington, KY 40504
Phone (859) 224-4081

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/aura_horn

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1346398799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 GREATSTONE PT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043274",
            "telephone_number": "859-224-4081",
            "fax_number": "859-224-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 GREATSTONE PT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043274",
            "telephone_number": "859-224-4081",
            "fax_number": "859-224-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "BETHANY",
        "middle_name": "COOPER",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "2425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100338720",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "COOPER",
            "middle_name": "ANNE",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.