Active NPI
Alexandra Theresa Nelson
- Speech-Language Pathologist
- Bridgeport, CT
National Provider Identifier
1659850196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5677
- Practice address
- 226 Mill Hill Ave
Bridgeport, CT 06610-2826 - Phone
- (203) 336-3637
- NPI assigned
- Aug 7, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 5677 | CT | Primary |
Addresses
Primary practice location
226 Mill Hill Ave
Bridgeport, CT 06610-2826
Mailing address
60 Wheeler Rd
Monroe, CT 06468-2458
Phone (210) 707-0798
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 |
|---|---|---|---|
| 5677 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533600000000",
"number": "1659850196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 WHEELER RD",
"city": "MONROE",
"state": "CT",
"postal_code": "064682458",
"telephone_number": "210-707-0798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 MILL HILL AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066102826",
"telephone_number": "203-336-3637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "ALEXANDRA",
"middle_name": "THERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-07",
"last_updated": "2018-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "5677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.