Midwest Myofunctional and Speech Therapy, LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

MIDWEST MYOFUNCTIONAL AND SPEECH THERAPY, LLC

Practice address

7221 Engle Rd Ste 225
Fort Wayne, IN 46804-2229

Phone

(260) 438-1430

NPI assigned

Jun 5, 2019

Organization subpart

No

Name

Julie A Carrico, SLPNPI 1720117393

Title

Speech-Language Pathologist

Phone

(260) 438-1430

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie A Carrico, SLP

  • Speech-Language Pathologist
  • Fort Wayne, IN
  • NPI 1720117393
  NPD Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 5, 2019.

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1164080974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10909 W SYCAMORE HILLS DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149335",
            "telephone_number": "260-438-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7221 ENGLE RD STE 225",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042229",
            "telephone_number": "260-438-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MYOFUNCTIONAL AND SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "CARRICO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "260-438-1430",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing and Speech Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.