Active NPI
Jane Mackie Syme
- Speech-Language Pathologist
- Ivoryton, CT
National Provider Identifier
1659836732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 00612
- Practice address
- 65 Main St Unit 29
Ivoryton, CT 06442-1031 - Phone
- (860) 575-5724
- NPI assigned
- Feb 4, 2019
- Last updated
- Feb 4, 2019
- 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 | 00612 | CT | Primary |
Addresses
Primary practice location
65 Main St Unit 29
Ivoryton, CT 06442-1031
Mailing address
65 Main St Unit 29
Ivoryton, CT 06442-1031
Phone (860) 575-5724
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 |
|---|---|---|---|
| 00612 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549238400000",
"number": "1659836732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 MAIN ST UNIT 29",
"city": "IVORYTON",
"state": "CT",
"postal_code": "064421031",
"telephone_number": "860-575-5724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 MAIN ST UNIT 29",
"city": "IVORYTON",
"state": "CT",
"postal_code": "064421031",
"telephone_number": "860-575-5724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYME",
"first_name": "JANE",
"middle_name": "MACKIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-04",
"last_updated": "2019-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "00612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ivoryton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.