Individual provider Active NPI

Hailey Dewitt

  • Speech-Language Pathologist
  • Liverpool, NY
National Provider Identifier
1457072274
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
115 Continuum Dr
Liverpool, NY 13088-4387
Phone
(673) 485-3119
NPI assigned
Sep 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 Primary

Addresses

Primary practice location

115 Continuum Dr
Liverpool, NY 13088-4387

Mailing address

4672 State Route 41a
Skaneateles, NY 13152-8500
Phone (315) 604-1775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230724000160 NC Practitioner - Qualified Speech Language Pathologist 3173983160 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Speech Therapy Inc Speech-Language Pathologist CurrentSince Jun 15, 2023 Accepting new patients

Locations

160 N NC 241 Hwy
Beulaville, NC 28518
Phone (888) 258-6905

124 E Park Dr
Beulaville, NC 28518
Phone (888) 258-6905

101 N Plain Rd
Jacksonville, NC 28546
Phone (888) 258-6905

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1457072274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4672 STATE ROUTE 41A",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131528500",
            "telephone_number": "315-604-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CONTINUUM DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884387",
            "telephone_number": "673-485-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "HAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.