Individual provider Active NPI

Elizabeth Randall Hatch

  • Speech-Language Pathologist
  • Brewer, ME
National Provider Identifier
1841507530
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP711 Issued in ME
Practice address
797 Wilson St Ste 2
Brewer, ME 04412-1003
Phone
(207) 947-8493
Fax
(207) 990-4819
NPI assigned
Sep 2, 2010
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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 SP711 ME Primary

Addresses

Primary practice location

797 Wilson St Ste 2
Brewer, ME 04412-1003

Mailing address

228 Palm St
Bangor, ME 04401-4022
Phone (207) 907-2283

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
SP711MEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Child Development Services PastSince Apr 1, 2022 Accepting new patients
Watch Me Shine, Inc. PastSince Jul 24, 2018 Accepting new patients

Organizations & group practices 2

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": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1841507530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 PALM ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014022",
            "telephone_number": "207-907-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 WILSON ST STE 2",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121003",
            "telephone_number": "207-947-8493",
            "fax_number": "207-990-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCH",
        "first_name": "ELIZABETH",
        "middle_name": "RANDALL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-02",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewer, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.