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  7. NPI Record 1548591621

MRS. MAUREEN RENEE VREDENBURGH M.A., CCC-SLP
Complete NPI Record 1548591621
Speech-Language Pathologist in East Syracuse, NY

NPI Status: Active since January 29, 2010

Contact Information

5820 HERITAGE LANDING DR
EAST SYRACUSE, NY
ZIP 13057
Phone: (315) 326-3351
Fax: (315) 701-1131

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider Other Last Name
  9. Provider Other First Name
  10. Provider Other Middle Name
  11. Provider Other Name Prefix Text
  12. Provider Other Credential Text
  13. Provider Other Last Name Type Code
  14. Provider First Line Business Mailing Address
  15. Provider Business Mailing Address City Name
  16. Provider Business Mailing Address State Name
  17. Provider Business Mailing Address Postal Code
  18. Provider Business Mailing Address Country Code If outside U S
  19. Provider Business Mailing Address Telephone Number
  20. Provider Business Mailing Address Fax Number
  21. Provider First Line Business Practice Location Address
  22. Provider Business Practice Location Address City Name
  23. Provider Business Practice Location Address State Name
  24. Provider Business Practice Location Address Postal Code
  25. Provider Business Practice Location Address Country Code If outside U S
  26. Provider Business Practice Location Address Telephone Number
  27. Provider Business Practice Location Address Fax Number
  28. Provider Enumeration Date
  29. Last Update Date
  30. Provider Gender Code
  31. Healthcare Provider Taxonomy Code 1
  32. Provider License Number 1
  33. Provider License Number State Code 1
  34. Healthcare Provider Primary Taxonomy Switch 1
  35. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1548591621. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1548591621
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: MAUREEN
The first name of the provider, if the provider is an individual.
Provider Middle Name: RENEE
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MRS.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: M.A., CCC-SLP
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name: MCCABE
Other last name by which the provider being identified is or has been known.
Provider Other First Name: MAUREEN
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Middle Name: RENEE
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider is or has been known by a different last name only.
Provider Other Name Prefix Text: MISS
The other name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Other Credential Text: M.A., CCC-SLP
The other abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name Type Code: 1
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider First Line Business Mailing Address: 4902 EDGEWORTH DR
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: MANLIUS
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 131042109
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 3153596900
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 3153596900
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 5820 HERITAGE LANDING DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: EAST SYRACUSE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NY
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 130579378
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Telephone Number: 3153263351
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3157011131
The State code in the location of the provider being identified.
Provider Enumeration Date: 1/29/2010
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Last Update Date: 1/29/2010
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 235Z00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 012107-1
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: NY
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.