Individual provider Active NPI

Sandra Harris Lindstrom, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Derby, NY
National Provider Identifier
1386912137
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005130 Issued in NY
Practice address
6745 Erie Rd
Derby, NY 14047-9670
Phone
(716) 926-2460
Fax
(716) 947-9269
NPI assigned
Dec 8, 2011
Last updated
Dec 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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 005130 NY Primary

Addresses

Primary practice location

6745 Erie Rd
Derby, NY 14047-9670

Mailing address

959 Beach Rd
Angola, NY 14006-9702
Phone (716) 926-2221

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
005130NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Evans-Brant Central School District Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1386912137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 BEACH RD",
            "city": "ANGOLA",
            "state": "NY",
            "postal_code": "140069702",
            "telephone_number": "716-926-2221",
            "fax_number": "716-549-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6745 ERIE RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479670",
            "telephone_number": "716-926-2460",
            "fax_number": "716-947-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS LINDSTROM",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.