Individual provider Active NPI

Emily Parks, SLP

  • Speech-Language Pathologist
  • Williamsville, NY
National Provider Identifier
1679146492
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
030866 Issued in NY
Practice address
100 College Pkwy Ste 100
Williamsville, NY 14221-6800
Phone
(716) 362-1552
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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 030866 NY Primary

Addresses

Primary practice location

100 College Pkwy Ste 100
Williamsville, NY 14221-6800

Mailing address

2900 Delaware Ave
Kenmore, NY 14217-2309
Phone (716) 871-9883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210813001272 NY Practitioner - Qualified Speech Language Pathologist 9537563457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030866NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Diversified Services for Occupational Therapy, Physical Therapy, Speec CurrentSince Sep 1, 2021 Accepting new patients
Diversified Services for Occupational Therapy, Physical Ther Speech-Language Pathologist Current Accepting new patients

Locations

2900 Delaware Ave
Kenmore, NY 14217
Phone (716) 262-9791

17 Limestone Dr
Ste 5
Williamsville, NY 14221
Phone (716) 362-1552

100 College Pkwy
Ste 100
Williamsville, NY 14221
Phone (716) 362-1552

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1679146492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172309",
            "telephone_number": "716-871-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY STE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216800",
            "telephone_number": "716-362-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "EMILY",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "030866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.