Individual provider Active NPI

Brenda Lee Machain, SLP

  • Speech-Language Pathologist
  • Gallup, NM
National Provider Identifier
1073644126
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3476 Issued in NM
Practice address
1000 E Aztec Ave
Gallup, NM 87301-5509
Phone
(505) 721-1800
Fax
(505) 721-1899
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3476 NM Primary

Addresses

Primary practice location

1000 E Aztec Ave
Gallup, NM 87301-5509

Mailing address

PO Box 1177
Fort Defiance, AZ 86504-1177
Phone (505) 777-2507

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gallup McKinley County Schools Past Accepting new patients

Organizations & group practices 1

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073644126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1177",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865041177",
            "telephone_number": "505-777-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015509",
            "telephone_number": "505-721-1800",
            "fax_number": "505-721-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHAIN",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "3476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.