Active NPI
Jennifer Robertson
- Speech-Language Pathologist
- Flushing, NY
National Provider Identifier
1831412949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 018597
- Practice address
- 14461 Roosevelt Ave
Flushing, NY 11354-6252 - Phone
- (718) 939-8700
- Fax
- (718) 939-0881
- NPI assigned
- Mar 3, 2010
- Last updated
- Mar 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 018597 | NY | Primary |
Addresses
Primary practice location
14461 Roosevelt Ave
Flushing, NY 11354-6252
Mailing address
14461 Roosevelt Ave
Flushing, NY 11354-6252
Phone (718) 939-8700
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Shield of David, Inc. | Current | Accepting new patients |
Locations
14461 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-1534
3909 214th Pl
Flushing, NY 11361
Phone (718) 229-5757
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1831412949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14461 ROOSEVELT AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113546252",
"telephone_number": "718-939-8700",
"fax_number": "718-939-0881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14461 ROOSEVELT AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113546252",
"telephone_number": "718-939-8700",
"fax_number": "718-939-0881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-03",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "018597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
- RKD Medical PLLC
- Robert B. Rho, M.D., P.C. (Liberty Women's Health Care of Queens - NYC)
- Robert S. Lee Therapeutic Massage, P.C.
- Toni Ann Roberti, L.AC.
- Susan Lloyd Roberts, O.T.R./L.
- Nii Amon Robertson, M.D.
- Robinson Physical Therapy PC
- Rivka D Robinson, PT, DPT
- Lee Anne Robison, MA
- Jovelyn Cadiz Roca, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.