Individual provider Active NPI

Patricia Marie Keating, M.A., CCC-SLP

  • Speech-Language Pathologist
  • West Henrietta, NY
National Provider Identifier
1669743795
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019431-1 Issued in NY
Practice address
172 Mossy Oak CV
West Henrietta, NY 14586-9352
Phone
(585) 469-1961
NPI assigned
Jan 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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 019431-1 NY Primary

Addresses

Primary practice location

172 Mossy Oak CV
West Henrietta, NY 14586-9352

Mailing address

172 Mossy Oak CV
West Henrietta, NY 14586-9352
Phone (585) 469-1961

Other identifiers 1

IdentifierTypeStateIssuer
01497492MedicaidNY

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
019431-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1669743795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 MOSSY OAK CV",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869352",
            "telephone_number": "585-469-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 MOSSY OAK CV",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869352",
            "telephone_number": "585-469-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATING",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019431-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01497492",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Henrietta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.

Verify at the official NPI Registry.