NPIMap

Organization Active NPI

Speech Pathology Solutions, LLC

  • Speech-Language Pathologist
  • West Creek, NJ
National Provider Identifier
1588930283
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00479900 Issued in NJ
Legal business name
SPEECH PATHOLOGY SOLUTIONS, LLC
Practice address
1064 S Main St BLDG 2C
West Creek, NJ 08092-2914
Phone
(609) 488-2650
Fax
(609) 488-2651
NPI assigned
Mar 27, 2012
Last updated
Jul 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kristy J Pantano, M.A.CCC-SLPNPI 1467577957
Title
Speech Language Pathologist/ Owner
Phone
(908) 216-1597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00479900 NJ Primary

Addresses

Primary practice location

1064 S Main St BLDG 2C
West Creek, NJ 08092-2914

Mailing address

1064 S Main St BLDG 2C
West Creek, NJ 08092-2914
Phone (908) 216-1597

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120315000048 NJ Part B Supplier - Clinic/Group Practice 4082873799 Receives reassigned benefits from 11 practitioners
Practice locations: Wall Township, NJ; West Creek, NJ

National Provider Directory

National Provider Directory

Locations

2101 State Route 34
Ste F
Wall Township, NJ 07719
Phone (732) 659-9536

1064 S Main St
Bldg 2C
West Creek, NJ 08092
Phone (609) 234-1796

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1588930283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 S MAIN ST BLDG 2C",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080922914",
            "telephone_number": "908-216-1597",
            "fax_number": "609-488-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 S MAIN ST BLDG 2C",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080922914",
            "telephone_number": "609-488-2650",
            "fax_number": "609-488-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH PATHOLOGY SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "PANTANO",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST/ OWNER",
        "authorized_official_telephone_number": "908-216-1597",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A.CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00479900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Creek, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.