Individual provider Active NPI

Marina Chebotayev O'Neil, SLP

  • Speech-Language Pathologist
  • Windsor, CT
National Provider Identifier
1649419151
Registry record updated Feb 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
003436 Issued in CT
Practice address
100 Deerfield Rd
Windsor, CT 06095-4252
Phone
(860) 714-9500
NPI assigned
Feb 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2009

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 003436 CT Primary

Addresses

Primary practice location

100 Deerfield Rd
Windsor, CT 06095-4252

Mailing address

179 Palmer Dr
South Windsor, CT 06074-2911
Phone (860) 644-4043

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

NPI Registry JSON

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

{
    "created_epoch": "1234051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234051200000",
    "number": "1649419151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 PALMER DR",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742911",
            "telephone_number": "860-644-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DEERFIELD RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060954252",
            "telephone_number": "860-714-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "MARINA",
        "middle_name": "CHEBOTAYEV",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-08",
        "last_updated": "2009-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2009; 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.