Individual provider Active NPI

Rebecca Plyler, CCC-SLP

  • Speech-Language Pathologist
  • Cromwell, CT
National Provider Identifier
1720484785
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
18.007497 Issued in CT
Practice address
110 Court St Ste 3
Cromwell, CT 06416-1273
Phone
(860) 613-9930
Fax
(860) 613-9952
NPI assigned
Nov 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 18.007497 CT Primary

Addresses

Primary practice location

110 Court St Ste 3
Cromwell, CT 06416-1273

Mailing address

110 Court St Ste 3
Cromwell, CT 06416-1273
Phone (860) 613-9930

Other names 1

  • Rebecca Marie Jackson Former name

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

LicenseStateTypeSpecialty
18.007497CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Education Assessment Consultation Services CurrentSince Oct 15, 2023 Accepting new patients
St. Colman'S Home Inc. Past Accepting new patients

Locations

110 Court St
Ste 3
Cromwell, CT 06416
Phone (860) 281-6271

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": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1720484785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COURT ST STE 3",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064161273",
            "telephone_number": "860-613-9930",
            "fax_number": "860-613-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 COURT ST STE 3",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064161273",
            "telephone_number": "860-613-9930",
            "fax_number": "860-613-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLYLER",
        "first_name": "REBECCA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "18.007497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "JACKSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.