Individual provider Active NPI

Alison Beth Sullivan

  • Speech-Language Pathologist
  • Fairport, NY
National Provider Identifier
1871898734
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
027750-1 Issued in NY
Practice address
41 Oconnor Rd
Fairport, NY 14450-1327
Phone
(585) 260-5289
NPI assigned
Jan 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 027750-1 NY Primary
Speech-Language Pathologist 235Z00000X O1-0001188 DE

Addresses

Primary practice location

41 Oconnor Rd
Fairport, NY 14450-1327

Mailing address

41 Oconnor Rd
Fairport, NY 14450-1327
Phone (585) 260-5289

Other practice location 1

200 Tyre Ave
Newark, DE 19711-7136
Phone (302) 454-2047 ext. 502

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
027750-1NYMDPediatric Physical Therapist
O1-0001188DEMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1871898734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 OCONNOR RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501327",
            "telephone_number": "585-260-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 OCONNOR RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501327",
            "telephone_number": "585-260-5289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Tyre Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197117136",
            "country_code": "US",
            "telephone_number": "302-454-2047 x502",
            "fax_number": "302-454-5442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ALISON",
        "middle_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027750-1",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "DE",
            "license": "O1-0001188",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.