Active NPI
Mary Ann Brandon, SLP
- Speech-Language Pathologist
- Michigan City, IN
National Provider Identifier
1093345175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22006257A
- Practice address
- 802 E US Highway 20
Michigan City, IN 46360-7424 - Phone
- (219) 861-3131
- NPI assigned
- Jan 17, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 22006257A | IN | Primary |
Addresses
Primary practice location
802 E US Highway 20
Michigan City, IN 46360-7424
Mailing address
802 E US Highway 20
Michigan City, IN 46360-7424
Phone (219) 861-3131
Other names 1
- Mary Ann Haynos
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22006257A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579219200000",
"number": "1093345175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 E US HIGHWAY 20",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463607424",
"telephone_number": "219-861-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 E US HIGHWAY 20",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463607424",
"telephone_number": "219-861-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDON",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22006257A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "HAYNOS",
"middle_name": "ANN",
"credential": "SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Michigan City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.