Active NPI
Elizabeth Grace Noll, M.S., CCC-SLP/L
- Speech-Language Pathologist
- Camillus, NY
National Provider Identifier
1598057788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 012335-1
- Practice address
- 300 Sanderson Dr
Camillus, NY 13031-1600 - Phone
- (315) 487-4698
- NPI assigned
- May 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 012335-1 | NY | Primary |
Addresses
Primary practice location
300 Sanderson Dr
Camillus, NY 13031-1600
Mailing address
3119 Gerald Lane
Baldwinsville, NY 13027
Phone (315) 635-6104
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 |
|---|---|---|---|
| 012335-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Genesee Central School District | 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.
-
- Local Education Agency (LEA)
- Camillus, NY
- NPI 1811042088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304640000000",
"number": "1598057788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3119 GERALD LANE",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "13027",
"telephone_number": "315-635-6104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SANDERSON DR",
"city": "CAMILLUS",
"state": "NY",
"postal_code": "130311600",
"telephone_number": "315-487-4698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLL",
"first_name": "ELIZABETH",
"middle_name": "GRACE",
"name_prefix": "Miss",
"credential": "M.S., CCC-SLP/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-06",
"last_updated": "2011-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "012335-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camillus, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.