Active NPI
Ann M Mixon, MS CCC-SLP
- Speech-Language Pathologist
- Garden City, NY
National Provider Identifier
1558697276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 018811-1
- Practice address
- 60 Fairmount Blvd
Garden City, NY 11530-5130 - Phone
- (516) 616-0302
- Fax
- (516) 437-0420
- NPI assigned
- Oct 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 018811-1 | NY | Primary |
Addresses
Primary practice location
60 Fairmount Blvd
Garden City, NY 11530-5130
Mailing address
60 Fairmount Blvd
Garden City, NY 11530-5130
Phone (516) 616-0302
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
| License | State | Type | Specialty |
|---|---|---|---|
| 018811-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256860800000",
"number": "1558697276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 FAIRMOUNT BLVD",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305130",
"telephone_number": "516-616-0302",
"fax_number": "516-437-0420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 FAIRMOUNT BLVD",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305130",
"telephone_number": "516-616-0302",
"fax_number": "516-437-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIXON",
"first_name": "ANN",
"middle_name": "M",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-30",
"last_updated": "2009-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "018811-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.