Active NPI
Phyllis Mazurski, M.S., CCC-SLP
- Speech-Language Pathologist
- Colchester, VT
National Provider Identifier
1356628093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 144-0126030
- Practice address
- 790 College Pkwy
Colchester, VT 05446-3007 - Phone
- (802) 847-3970
- NPI assigned
- Nov 9, 2011
- Sex
- Female
- 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 | 144-0126030 | VT | Primary |
Addresses
Primary practice location
790 College Pkwy
Colchester, VT 05446-3007
Mailing address
790 College Pkwy
Colchester, VT 05446-3007
Phone (802) 847-3970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03954 | Medicaid | NY |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 144-0126030 | VT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490486400000",
"number": "1356628093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 COLLEGE PKWY",
"city": "COLCHESTER",
"state": "VT",
"postal_code": "054463007",
"telephone_number": "802-847-3970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 COLLEGE PKWY",
"city": "COLCHESTER",
"state": "VT",
"postal_code": "054463007",
"telephone_number": "802-847-3970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZURSKI",
"first_name": "PHYLLIS",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-09",
"last_updated": "2017-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VT",
"license": "144-0126030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03954",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colchester, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.