Individual provider Active NPI

Elizabeth Leigh Elmer, MS

  • Speech-Language Pathologist
  • Black River, NY
National Provider Identifier
1710289244
Registry record updated Dec 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
006217 Issued in NY
Practice address
160 Leray St
Black River, NY 13612-2114
Phone
(315) 773-5911
NPI assigned
Dec 5, 2010
Last updated
Dec 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2010

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 006217 NY Primary

Addresses

Primary practice location

160 Leray St
Black River, NY 13612-2114

Mailing address

22269 Riverglade Dr
Watertown, NY 13601-1773
Phone (315) 786-6634

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 Science

NPI Registry JSON

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

{
    "created_epoch": "1291507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291507200000",
    "number": "1710289244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22269 RIVERGLADE DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011773",
            "telephone_number": "315-786-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 LERAY ST",
            "city": "BLACK RIVER",
            "state": "NY",
            "postal_code": "136122114",
            "telephone_number": "315-773-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMER",
        "first_name": "ELIZABETH",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-05",
        "last_updated": "2010-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "006217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2010; 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.