NPIMap

Organization Active NPI

Complete SLP, OT, PT & Psychology Services, PLLC

  • Contractor
  • Bronx, NY
National Provider Identifier
1437616026
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
COMPLETE SLP, OT, PT & PSYCHOLOGY SERVICES, PLLC
Practice address
3410 Grace Ave
Bronx, NY 10469-2612
Phone
(203) 809-9948
NPI assigned
Mar 1, 2019
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Keitha Stevens, MA, CCC-SLPNPI 1164665196
Title
SLP
Phone
(646) 897-6963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

3410 Grace Ave
Bronx, NY 10469-2612

Mailing address

3410 Grace Ave
Bronx, NY 10469-2612
Phone (203) 809-9948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190605000339 NY Part B Supplier - Clinic/Group Practice 4486987500 Receives reassigned benefits from 33 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1437616026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 GRACE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692612",
            "telephone_number": "203-809-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 GRACE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692612",
            "telephone_number": "203-809-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE SLP, OT, PT & PSYCHOLOGY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-01",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "KEITHA",
        "authorized_official_title_or_position": "SLP",
        "authorized_official_telephone_number": "646-897-6963",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.