Individual provider Active NPI

Kerri L Roloson, LPN

  • Speech-Language Pathologist
  • Wantagh, NY
National Provider Identifier
1982862983
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0150531 Issued in NY
Practice address
950 Annette Dr
Wantagh, NY 11793-1008
Phone
(516) 785-9203
NPI assigned
May 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 235142-1 NY
Speech-Language Pathologist 235Z00000X 0150531 NY Primary

Addresses

Primary practice location

950 Annette Dr
Wantagh, NY 11793-1008

Mailing address

950 Annette Dr
Wantagh, NY 11793-1008
Phone (516) 785-9203

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
235142-1NYMDLicensed Practical Nurse
0150531NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1982862983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 ANNETTE DR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931008",
            "telephone_number": "516-785-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 ANNETTE DR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931008",
            "telephone_number": "516-785-9203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLOSON",
        "first_name": "KERRI",
        "middle_name": "L",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "235142-1",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0150531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.