Active NPI
Craig Steven McIntire-Mann, MS CCC-SLP
- Speech-Language Pathologist
- Walnut Creek, CA
National Provider Identifier
1053694281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 15246
- Practice address
- 14 Oak Treat CT
Walnut Creek, CA 94597-6700 - Phone
- (925) 308-5717
- NPI assigned
- Sep 23, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 15246 | CA | Primary |
Addresses
Primary practice location
14 Oak Treat CT
Walnut Creek, CA 94597-6700
Mailing address
14 Oak Treat CT
Walnut Creek, CA 94597-6700
Other practice location 1
1592 Sunnyvale Ave
#26
Walnut Creek, CA 94597-1934
Phone (925) 330-8429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Converge Speech Therapy | Current | Accepting new patients | |
| Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc | Current | Accepting new patients | |
| Orthopaedic and Neurological Rehab Inc | Current | Accepting new patients |
Locations
4751 Dallas Ranch Rd
Antioch, CA 94531
Phone (925) 350-0291
2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017
8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252
Organizations & group practices 3
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.
-
- Hearing and Speech Clinic/Center
- Walnut Creek, CA
- NPI 1003485939
-
- Rehabilitation Clinic/Center
- Tustin, CA
- NPI 1548940885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627516800000",
"number": "1053694281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 OAK TREAT CT",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945976700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 OAK TREAT CT",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945976700",
"telephone_number": "925-308-5717"
}
],
"practiceLocations": [
{
"address_1": "1592 Sunnyvale Ave",
"address_2": "#26",
"address_purpose": "LOCATION",
"city": "Walnut Creek",
"state": "CA",
"postal_code": "945971934",
"country_code": "US",
"telephone_number": "925-330-8429",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCINTIRE-MANN",
"first_name": "CRAIG",
"middle_name": "STEVEN",
"name_prefix": "Mr.",
"credential": "MS CCC-SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-23",
"last_updated": "2021-07-29",
"certification_date": "2021-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "15246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.