Individual provider Active NPI

Megan Reddick, MS, CCC-SLP

  • Speech-Language Pathologist
  • Watertown, NY
National Provider Identifier
1932947157
Registry record updated Jul 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
027466 Issued in NY
Practice address
706 Greensview Dr
Watertown, NY 13601-3957
Phone
(315) 767-3333
NPI assigned
Jul 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2024

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 027466 NY Primary

Addresses

Primary practice location

706 Greensview Dr
Watertown, NY 13601-3957

Mailing address

706 Greensview Dr
Watertown, NY 13601-3957
Phone (315) 767-3333

Other names 1

  • Megan Cullen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016002818 NY Practitioner - Qualified Speech Language Pathologist 0244762102 Reassigns benefits to 1 organization
Practice locations: Watertown, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
027466NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Well Speak Speech Therapy, PLLC Speech-Language Pathologist CurrentSince Oct 8, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1932947157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 GREENSVIEW DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013957",
            "telephone_number": "315-767-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 GREENSVIEW DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013957",
            "telephone_number": "315-767-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDICK",
        "first_name": "MEGAN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-20",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "CULLEN",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.