Alissa L Waughtel

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

023460-1 Issued in NY

Practice address

5990 Ivory Dr
Farmington, NY 14425-9073

Phone

(315) 882-4490

NPI assigned

Jan 7, 2013

Last updated

Aug 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1922345255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5990 IVORY DR",
            "city": "FARMINGTON",
            "state": "NY",
            "postal_code": "144259073",
            "telephone_number": "315-882-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5990 IVORY DR",
            "city": "FARMINGTON",
            "state": "NY",
            "postal_code": "144259073",
            "telephone_number": "315-882-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUGHTEL",
        "first_name": "ALISSA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "023460-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle M Tucker
• Victor Association of Cultural and Performing Arts
• Farley Wagner, PT
• Walter J. Deck, D.M.D., P.C.
• Melody L Waugh, LMSW
• Niki Kristine West, NP
• Joel A Yellin, MD
• Jim Carl Tamala Yu, PTA, PT

• Speech-Language Pathologist in Farmington, NY
• Providers in Farmington, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.