Individual provider Active NPI

Marianne McQuade Van Kessel, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Bend, OR
National Provider Identifier
1073807756
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11396 Issued in OR
Practice address
2599 NE Studio Rd
Bend, OR 97701-9878
Phone
(541) 383-2030
NPI assigned
May 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2011

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 11396 OR Primary

Addresses

Primary practice location

2599 NE Studio Rd
Bend, OR 97701-9878

Mailing address

2599 NE Studio Rd
Bend, OR 97701-9878
Phone (541) 383-2030

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
11396ORMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1073807756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2599 NE STUDIO RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019878",
            "telephone_number": "541-383-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2599 NE STUDIO RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019878",
            "telephone_number": "541-383-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KESSEL",
        "first_name": "MARIANNE",
        "middle_name": "MCQUADE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "11396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.