Bonnie L Vaillancourt, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1002 Issued in NH

Practice address

148 Key Road Suite B
Keene, NH 03431-3927

Phone

(603) 352-4199

Fax

(603) 352-9177

NPI assigned

May 10, 2007

Last updated

Sep 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Simplified Speech Solutions LLC

  • Speech-Language Pathologist
  • Keene, NH
  • NPI 1245549534
  NPD Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1639383441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 KEY ROAD SUITE B",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313927",
            "telephone_number": "603-352-4199",
            "fax_number": "603-352-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 KEY ROAD SUITE B",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313927",
            "telephone_number": "603-352-4199",
            "fax_number": "603-352-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAILLANCOURT",
        "first_name": "BONNIE",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "1002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3072519",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "66Y011060NH01",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Keene",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "148 Key Rd Ste B",
            "city": "Keene",
            "state": "NH",
            "country_code": "US",
            "postal_code": "034313927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Keene, NH
• Providers in Keene, NH by specialty
• Speech-Language Pathologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.