Individual provider Active NPI

Channon Klein Giller, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Howard Beach, NY
National Provider Identifier
1962656959
Registry record updated Oct 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
014947-1 Issued in NY
Practice address
15645 84TH St
Howard Beach, NY 11414-2617
Phone
(718) 738-1800
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2010

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 014947-1 NY Primary

Addresses

Primary practice location

15645 84TH St
Howard Beach, NY 11414-2617

Mailing address

556 Derby Ave
Woodmere, NY 11598-2713
Phone (516) 569-1648

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
014947-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Toddler Infant Preschool Past Accepting new patients
Special Kids Intervention Program, Inc Past Accepting new patients

Organizations & group practices 2

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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1962656959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 DERBY AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982713",
            "telephone_number": "516-569-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15645 84TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142617",
            "telephone_number": "718-738-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN GILLER",
        "first_name": "CHANNON",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "014947-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; 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.