Individual provider Active NPI

Lidia Whitted, M.S.SLP

  • Speech-Language Pathologist
  • Mahopac, NY
National Provider Identifier
1750654125
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020722 Issued in NY
Practice address
107 Baldwin Place Rd
Mahopac, NY 10541-2212
Phone
(914) 391-7926
NPI assigned
Feb 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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 020722 NY Primary

Addresses

Primary practice location

107 Baldwin Place Rd
Mahopac, NY 10541-2212

Mailing address

107 Baldwin Place Rd
Mahopac, NY 10541-2212
Phone (914) 391-7926

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325002652 TN Practitioner - Qualified Speech Language Pathologist 7810410495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020722NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Rehabilitation Services LLC CurrentSince Feb 3, 2025 Accepting new patients

Locations

1227 N Washington Ave
Ste 106
Cookeville, TN 38501
Phone (931) 400-0724

370 S Lowe Ave
Ste A330
Cookeville, TN 38501
Phone (606) 224-6915

Organizations & group practices 1

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": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1750654125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BALDWIN PLACE RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412212",
            "telephone_number": "914-391-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BALDWIN PLACE RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412212",
            "telephone_number": "914-391-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTED",
        "first_name": "LIDIA",
        "name_prefix": "Mrs.",
        "credential": "M.S.SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.