Debra Ann Nimmo, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

005533-1 Issued in NY

Practice address

3299 Beltagh Ave
Wantagh, NY 11793-3362

Phone

(516) 679-6310

NPI assigned

Oct 18, 2012

Last updated

Oct 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1730432519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 NICHOLAS CT",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117144616",
            "telephone_number": "516-931-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3299 BELTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933362",
            "telephone_number": "516-679-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMO",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005533-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGIST LICENSE NUMBER",
            "identifier": "005533-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA CERTIFICATION",
            "identifier": "010-715-05",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.