Active NPI
Nicole A Fox, CCC-SLP, TSSLD
- Speech-Language Pathologist
- Broad Channel, NY
National Provider Identifier
1609323492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 027559-1
- Practice address
- 21 W 14TH Rd
Broad Channel, NY 11693-1138 - Phone
- (917) 748-6140
- NPI assigned
- Sep 8, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | |||
| Speech-Language Pathologist | 235Z00000X | 027559-1 | NY | Primary |
Addresses
Primary practice location
21 W 14TH Rd
Broad Channel, NY 11693-1138
Mailing address
21 W 14TH Rd
Broad Channel, NY 11693-1138
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
| License | State | Type | Specialty |
|---|---|---|---|
| 027559-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1609323492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 W 14TH RD",
"city": "BROAD CHANNEL",
"state": "NY",
"postal_code": "116931138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 W 14TH RD",
"city": "BROAD CHANNEL",
"state": "NY",
"postal_code": "116931138",
"telephone_number": "917-748-6140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOX",
"first_name": "NICOLE",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "CCC-SLP, TSSLD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-08",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "027559-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broad Channel, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.