Individual provider Active NPI

Mary K. Clift, MS CCC-SLP

  • Speech-Language Pathologist
  • Louisville, KY
National Provider Identifier
1124157870
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22002861A Issued in IN
Practice address
4409 Creekcrossing Dr
Louisville, KY 40241-5511
Phone
(502) 291-7099
Fax
(502) 228-6748
NPI assigned
Mar 5, 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 22002861A IN Primary

Addresses

Primary practice location

4409 Creekcrossing Dr
Louisville, KY 40241-5511

Mailing address

4409 Creekcrossing Dr
Louisville, KY 40241-5511
Phone (502) 291-7099

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22002861AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124157870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 CREEKCROSSING DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402415511",
            "telephone_number": "502-291-7099",
            "fax_number": "502-228-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 CREEKCROSSING DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402415511",
            "telephone_number": "502-291-7099",
            "fax_number": "502-228-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFT",
        "first_name": "MARY",
        "middle_name": "K.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002861A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

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.