Individual provider Active NPI

Sandra Marie Schulze, M.S.CCC-SLP

  • Speech-Language Pathologist
  • Groton, CT
National Provider Identifier
1780937557
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
002255 Issued in CT
Practice address
1145 Poquonnock Rd
Groton, CT 06340-4620
Phone
(860) 446-9960
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 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 002255 CT Primary

Addresses

Primary practice location

1145 Poquonnock Rd
Groton, CT 06340-4620

Mailing address

17 Willow LN
Clinton, CT 06413-1526
Phone (860) 664-4582

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
002255CTMDSpeech-Language Pathologist

NPI Registry JSON

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": "1780937557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WILLOW LN",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064131526",
            "telephone_number": "860-664-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404620",
            "telephone_number": "860-446-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZE",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S.CCC-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": "CT",
            "license": "002255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • 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.