Individual provider Active NPI

Joel Wentworth, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Chester, NY
National Provider Identifier
1366695330
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
009918-1 Issued in NY
Practice address
6 Wright Rd
Chester, NY 10918-1716
Phone
(845) 216-4381
Fax
(845) 610-3247
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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 009918-1 NY Primary

Addresses

Primary practice location

6 Wright Rd
Chester, NY 10918-1716

Mailing address

6 Wright Rd
Chester, NY 10918-1716
Phone (845) 216-4381

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

LicenseStateTypeSpecialty
009918-1NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1366695330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WRIGHT RD",
            "city": "CHESTER",
            "state": "NY",
            "postal_code": "109181716",
            "telephone_number": "845-216-4381",
            "fax_number": "845-610-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WRIGHT RD",
            "city": "CHESTER",
            "state": "NY",
            "postal_code": "109181716",
            "telephone_number": "845-216-4381",
            "fax_number": "845-610-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "JOEL",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "009918-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.