Ashley Atwater Avery, M.S. CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Canandaigua, NY
NPI 1811238355 · NPPES record last updated Dec 10, 2013
Key facts
- NPI
- 1811238355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 022478-1 (NY)
- Practice address
- 5415 N Bloomfield Rd
Canandaigua, NY 14424-7964 - Phone
- (585) 394-9510
- Fax
- (585) 394-5326
- NPI assigned
- Mar 8, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Finger Lakes United Cerebral Palsy, Inc.
Practice addresses (Care Compare)
5415 County Rd
Suite 30
Canandaigua, NY 14424-7964
Phone (585) 394-9510
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131213001230 | NY | Practitioner - Qualified Speech Language Pathologist | 1557598745 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022478 | NY | MD | Physical Therapist |
| 022478-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Finger Lakes United Cerebral Palsy, Inc. | Current |
Accepting new patients |
Locations
5415 N Bloomfield Rd
Canandaigua, NY 14424
Phone (585) 394-1190
731 Pre Emption Rd
Geneva, NY 14456
Phone (315) 789-6828
1065 Lochland Rd
Geneva, NY 14456
Phone (315) 789-5208
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 022478-1 | NY | Yes |
Addresses
Primary practice location
5415 N Bloomfield Rd
Canandaigua, NY 14424-7964
Mailing address
731 Pre Emption Rd
Geneva, NY 14456-1335
Phone (315) 789-6828
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03574141 | Medicaid | NY |
Other names
- Ms. Ashley Webster Atwater
Other providers in Canandaigua, NY
- Marisa Andrews
- Anthony L. Jordan Health Corporation
- Lori A. Antonitto
- Amy Atwater
- Dale Hugh Austin
- Axismed Solutions, LLC
- Sierra Ayers
- Robert Barton Babcock
- Jillian Jean Babu
- Ilene Michelle Badain
All providers in Canandaigua, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.