Individual provider Active NPI

Emma Rose Marek, MS CCC-SLP

  • Speech-Language Pathologist
  • Austin, TX
National Provider Identifier
1093223885
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
110324 Issued in TX
Practice address
2700 Norfolk Drive
Austin, TX 78745
Phone
(315) 368-3274
NPI assigned
Jan 16, 2018
Last updated
Jan 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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 110324 TX Primary

Addresses

Primary practice location

2700 Norfolk Drive
Austin, TX 78745

Mailing address

2504 Bliss Spillar Rd
Manchaca, TX 78652-4409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250102000414 MA Practitioner - Qualified Speech Language Pathologist 7719414713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
110324TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Move for Life Physical Therapy LLC Speech-Language Pathologist CurrentSince Oct 24, 2024 Accepting new patients
On Site Dermatology of Massachusetts, LLC PastSince Oct 24, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1093223885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 BLISS SPILLAR RD",
            "city": "MANCHACA",
            "state": "TX",
            "postal_code": "786524409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NORFOLK DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78745",
            "telephone_number": "315-368-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAREK",
        "first_name": "EMMA",
        "middle_name": "ROSE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.

Verify at the official NPI Registry.