Individual provider Active NPI

Jennifer Lee Yanik, M.S., ED., CCC-SLP

  • Speech-Language Pathologist
  • Rome, NY
National Provider Identifier
1487955886
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020521 Issued in NY
Practice address
95 Dart Cir
Rome, NY 13441-4231
Phone
(315) 334-7200
NPI assigned
Nov 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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 020521 NY Primary

Addresses

Primary practice location

95 Dart Cir
Rome, NY 13441-4231

Mailing address

8682 Long Hill Rd
Rome, NY 13440-9316
Phone (315) 339-1493

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
020521NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1487955886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8682 LONG HILL RD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134409316",
            "telephone_number": "315-339-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 DART CIR",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134414231",
            "telephone_number": "315-334-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANIK",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "M.S., ED., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.