Ellen Rae Mock, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0003430 Issued in CO

Practice address

6767 S Broadway
Littleton, CO 80122-8002

Phone

(303) 731-1962

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Legacy Healthcare Services Inc.

  • Physical Therapist
  • Denver, CO
  • NPI 1164620084

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1124599386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 S BROADWAY",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801228002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 S BROADWAY",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801228002",
            "telephone_number": "303-731-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "ELLEN",
        "middle_name": "RAE",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0003430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francisca Mix, MA, LPC, BC-DMT, ACS
• Mona Mix
• Ali Moaddeli
• Mobile Podiatry Group PLLC
• Sarah Mobley, NP
• Modern Sleep Airway & Orthodontics LLC
• Stephanie Modica, R.D., CDE
• Julie Ann Moe
• Braden K. Mogler, MD
• Elizabeth Eastman Mogno, MSOT, OTR/L

• Speech-Language Pathologist in Littleton, CO
• Providers in Littleton, CO by specialty
• Speech-Language Pathologist in Colorado

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