Individual provider Active NPI

Judith Hanson Hancock, CCC-SLP

  • Speech-Language Pathologist
  • Binghamton, NY
National Provider Identifier
1619275054
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
004817-1 Issued in NY
Practice address
435 Glenwood Rd
Binghamton, NY 13905-1606
Phone
(607) 763-3318
Fax
(607) 763-3214
NPI assigned
Mar 9, 2011
Last updated
Mar 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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 004817-1 NY Primary

Addresses

Primary practice location

435 Glenwood Rd
Binghamton, NY 13905-1606

Mailing address

435 Glenwood Rd
Binghamton, NY 13905-1606
Phone (607) 763-3318

Other identifiers 2

IdentifierTypeStateIssuer
01033362OtherCERTIFICATE OF CLINICAL COMPETENCE - SPEECH-LANGUAGE PATHOLOGIST (CCC-SLP)
004817-1OtherNYS LICENSED SPEECH-LANGUAGE PATHOGIST

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
004817-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1619275054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 GLENWOOD RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051606",
            "telephone_number": "607-763-3318",
            "fax_number": "607-763-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 GLENWOOD RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051606",
            "telephone_number": "607-763-3318",
            "fax_number": "607-763-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "JUDITH",
        "middle_name": "HANSON",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "004817-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF CLINICAL COMPETENCE - SPEECH-LANGUAGE PATHOLOGIST (CCC-SLP)",
            "identifier": "01033362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSED SPEECH-LANGUAGE PATHOGIST",
            "identifier": "004817-1",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.

Verify at the official NPI Registry.