Individual provider Active NPI

Sara Gersley Cooper

  • Speech-Language Pathologist
  • East Hartford, CT
National Provider Identifier
1427431972
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4923 Issued in CT
Practice address
51 Applegate LN
East Hartford, CT 06118-1201
Phone
(732) 267-3360
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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 4923 CT Primary

Addresses

Primary practice location

51 Applegate LN
East Hartford, CT 06118-1201

Mailing address

51 Applegate LN
East Hartford, CT 06118-1201
Phone (732) 267-3360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260611000476 CT Practitioner - Qualified Speech Language Pathologist 4688146657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17 Willieb St
Glastonbury, CT 06033-3043

PO Box
821322 Attn Powerback Credentialing Dept
Philadelphia, PA 19182-1322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4923CTMDFamily Nurse Practitioner

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1427431972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 APPLEGATE LN",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181201",
            "telephone_number": "732-267-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 APPLEGATE LN",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181201",
            "telephone_number": "732-267-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SARA",
        "middle_name": "GERSLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "4923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.