Active NPI
Mary J Prime-Nelson, MS, CCC/SLP
- Speech-Language Pathologist
- New Rochelle, NY
National Provider Identifier
1861646044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 007573-1
- Practice address
- 300 Pelham Rd
#7H
New Rochelle, NY 10805-2238 - Phone
- (352) 300-0706
- Fax
- (914) 355-5320
- NPI assigned
- Nov 13, 2008
- 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 | 007573-1 | NY | Primary |
Addresses
Primary practice location
300 Pelham Rd
#7H
New Rochelle, NY 10805-2238
Mailing address
300 Pelham Rd
#7H
New Rochelle, NY 10805-2238
Phone (352) 300-0706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81-3121444 | Other | NY | IRS |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007573-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1861646044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PELHAM RD",
"address_2": "#7H",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108052238",
"telephone_number": "352-300-0706",
"fax_number": "914-355-5320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PELHAM RD",
"address_2": "#7H",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108052238",
"telephone_number": "352-300-0706",
"fax_number": "914-355-5320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIME-NELSON",
"first_name": "MARY",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "MS, CCC/SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-13",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "007573-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IRS",
"identifier": "81-3121444",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Rochelle, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.