Individual provider Active NPI

Anna Wyluda, SPEECH THERAPIST

  • Speech-Language Pathologist
  • Cheshire, CT
National Provider Identifier
1457923922
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6603 Issued in CT
Practice address
382 S Main St
Cheshire, CT 06410-1379
Phone
(203) 250-9663
Fax
(203) 699-9641
NPI assigned
Jul 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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 6603 CT Primary

Addresses

Primary practice location

382 S Main St
Cheshire, CT 06410-1379

Mailing address

382 S Main St
Cheshire, CT 06410-1379
Phone (203) 250-9663

Other practice location 1

308 Racebrook Road
Orange, CT 06477-0647
Phone (203) 920-1885

Other practice location 2

1064 E Main St Fl 3
Meriden, CT 06450-4898
Phone (203) 250-9663

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

State licenses

LicenseStateTypeSpecialty
6603CTMDMechanotherapist

Practice roles

OrganizationSpecialtyStatusNew patients
Express Success Current Accepting new patients
Cheshire Fitness Zone, LLC Speech-Language Pathologist CurrentSince Jul 25, 2021 Accepting new patients

Locations

382 S Main St
Cheshire, CT 06410

1064 E Main St
Fl 3
Meriden, CT 06450
Phone (203) 237-1818

1064 E Main St
Meriden, CT 06450
Phone (203) 235-9622

308 Racebrook Rd
Orange, CT 06477
Phone (203) 920-1885

157 Litchfield St
Torrington, CT 06790
Phone (860) 489-1328

Organizations & group practices 2

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": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1457923922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101379",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101379",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Racebrook Road",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CT",
            "postal_code": "064770647",
            "country_code": "US",
            "telephone_number": "203-920-1885",
            "fax_number": "203-920-1881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1064 E Main St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Meriden",
            "state": "CT",
            "postal_code": "064504898",
            "country_code": "US",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYLUDA",
        "first_name": "ANNA",
        "credential": "SPEECH THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "6603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.