Individual provider Active NPI

Major Douglas Cheatham, MA CCC/SLP

  • Speech-Language Pathologist
  • Carmel, NY
National Provider Identifier
1760644868
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
006376-1 Issued in NY
Practice address
1938 Route 6
Carmel, NY 10512-2311
Phone
(845) 225-5650
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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 006376-1 NY Primary

Addresses

Primary practice location

1938 Route 6
Carmel, NY 10512-2311

Mailing address

10 Wimisink Rd
Sherman, CT 06784-1132

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
006376-1NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1760644868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WIMISINK RD",
            "city": "SHERMAN",
            "state": "CT",
            "postal_code": "067841132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 ROUTE 6",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122311",
            "telephone_number": "845-225-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "MAJOR",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MA CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "006376-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.