Individual provider Active NPI

Rose Ann A Southard, MS-CF, TSSLD

  • Speech-Language Pathologist
  • Hicksville, NY
National Provider Identifier
1972822781
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020049-1 Issued in NY
Practice address
12 Cable LN
Cable Lane
Hicksville, NY 11801-6103
Phone
(516) 659-8031
NPI assigned
May 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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 020049-1 NY Primary

Addresses

Primary practice location

12 Cable LN
Cable Lane
Hicksville, NY 11801-6103

Mailing address

12 Cable LN
Cable Lane
Hicksville, NY 11801-6103
Phone (516) 659-8031

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
020049-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1972822781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CABLE LN",
            "address_2": "CABLE LANE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016103",
            "telephone_number": "516-659-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CABLE LN",
            "address_2": "CABLE LANE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016103",
            "telephone_number": "516-659-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "ROSE ANN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MS-CF, TSSLD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020049-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.