Individual provider Active NPI

Nicole M Buccieri-Aldridge, SPEECH-LANGUAGE PATH

  • Speech-Language Pathologist
  • Newport News, VA
National Provider Identifier
1497250633
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006157 Issued in VA
Practice address
729 Thimble Shoals Blvd
Ste 4-C
Newport News, VA 23606
Phone
(757) 873-2932
Fax
(757) 873-8780
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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 2202006157 VA Primary

Addresses

Primary practice location

729 Thimble Shoals Blvd
Ste 4-C
Newport News, VA 23606

Mailing address

729 Thimble Shoals Blvd
Ste 4-C
Newport News, VA 23606
Phone (757) 873-2932

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
2202006157VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Physical Therapy & Associates Inc. Speech-Language Pathologist Past Accepting new patients

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1497250633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD",
            "address_2": "STE 4-C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-873-2932",
            "fax_number": "757-873-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD",
            "address_2": "STE 4-C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-873-2932",
            "fax_number": "757-873-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCIERI-ALDRIDGE",
        "first_name": "NICOLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "SPEECH-LANGUAGE PATH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.