Individual provider Active NPI

Bridget C Nanna, SLP

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1881978393
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9301-1 Issued in NY
Practice address
4115 Lake Ave
Rochester, NY 14612-4813
Phone
(585) 663-7070
NPI assigned
Oct 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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 9301-1 NY Primary

Addresses

Primary practice location

4115 Lake Ave
Rochester, NY 14612-4813

Mailing address

3 Chamber Valley Estates
Spencerport, NY 14559
Phone (585) 663-7070

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
9301-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1881978393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CHAMBER VALLEY ESTATES",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "14559",
            "telephone_number": "585-663-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146124813",
            "telephone_number": "585-663-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANNA",
        "first_name": "BRIDGET",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "9301-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.