Individual provider Active NPI

Marissa Silva, M.S. CCC, SLP

  • Speech-Language Pathologist
  • Columbia, SC
National Provider Identifier
1104547736
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8178 Issued in SC
Practice address
1040 Wildwood Centre Dr
Columbia, SC 29229-8402
Phone
(803) 567-3348
Fax
(803) 728-3044
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8178 SC Primary
Speech-Language Pathologist 235Z00000X 37681 CA

Addresses

Primary practice location

1040 Wildwood Centre Dr
Columbia, SC 29229-8402

Mailing address

120 Beacon LN
Columbia, SC 29229-7524
Phone (559) 901-8235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, SC, NY, WA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20240912002441 CA Practitioner - Qualified Speech Language Pathologist 2567902885 Reassigns benefits to 1 organization
I20240913000782 SC Practitioner - Qualified Speech Language Pathologist 2567902885 Reassigns benefits to 1 organization
I20240927002957 NY Practitioner - Qualified Speech Language Pathologist 2567902885 Reassigns benefits to 1 organization
I20250108000866 WA Practitioner - Qualified Speech Language Pathologist 2567902885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Expressable Speech-Language Pathology PCGroup PAC ID 4688074511, 115 clinicians

Practice addresses (Care Compare)

633 W 5TH St
Ofc 2876B
Los Angeles, CA 90071-2005
Phone (512) 399-0064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8178SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Oct 14, 2024 Accepting new patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Oct 14, 2024 Accepting new patients

Locations

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

99 Hudson St
Fl 5
New York, NY 10013
Phone (646) 301-2578

4000 Faber Place Dr
Ste 300
North Charleston, SC 29405
Phone (704) 956-3062

7600 Chevy Chase Dr
Austin, TX 78752
Phone (512) 649-3880

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

506 2nd Ave
Ste 1400
Seattle, WA 98104
Phone (206) 486-8077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1104547736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BEACON LN",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297524",
            "telephone_number": "559-901-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 WILDWOOD CENTRE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298402",
            "telephone_number": "803-567-3348",
            "fax_number": "803-728-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA",
        "first_name": "MARISSA",
        "credential": "M.S. CCC, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8178",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "37681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.