Individual provider Active NPI

Mary Manzione, MS, CCC-SLP

  • Speech-Language Pathologist
  • Annandale, VA
National Provider Identifier
1144453093
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202004230 Issued in VA
Practice address
7617 Little River Tpke
Suite 310
Annandale, VA 22003-2603
Phone
(703) 941-7757
NPI assigned
Aug 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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 2202004230 VA Primary

Addresses

Primary practice location

7617 Little River Tpke
Suite 310
Annandale, VA 22003-2603

Mailing address

7617 Little River Tpke
Suite 310
Annandale, VA 22003-2603
Phone (703) 941-7757

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
2202004230VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Skill Builders, LLC Speech-Language Pathologist Past Accepting new patients
Skill Builders, LLC Speech-Language Pathologist Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1144453093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 LITTLE RIVER TPKE",
            "address_2": "SUITE 310",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032603",
            "telephone_number": "703-941-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 LITTLE RIVER TPKE",
            "address_2": "SUITE 310",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032603",
            "telephone_number": "703-941-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZIONE",
        "first_name": "MARY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; 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.