Individual provider Active NPI

Archana Chinnappan, CCC-SLP

  • Speech-Language Pathologist
  • Marlton, NJ
National Provider Identifier
1174074124
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01037600 Issued in NJ
Practice address
751 Route 73 N Ste 1
Marlton, NJ 08053-3456
Phone
(856) 375-2914
NPI assigned
Oct 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Speech-Language Pathologist 235Z00000X SL015563 PA
Speech-Language Pathologist 235Z00000X 41YS01037600 NJ Primary

Addresses

Primary practice location

751 Route 73 N Ste 1
Marlton, NJ 08053-3456

Mailing address

751 Route 73 N
Marlton, NJ 08053-3463

Other practice location 1

10 Parsonage Rd
Edison, NJ 08837-2429
Phone (888) 261-1110

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

State licenses

LicenseStateTypeSpecialty
41YS01037600NJMDSpeech-Language Pathologist
SL015563PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MJ Kidz LLC Speech-Language Pathologist CurrentSince Nov 15, 2023 Accepting new patients

Locations

751 Route 73 N
Ste 1
Marlton, NJ 08053
Phone (856) 823-1793

Organizations & group practices 1

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": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1174074124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 ROUTE 73 N",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 ROUTE 73 N STE 1",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533456",
            "telephone_number": "856-375-2914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Parsonage Rd",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088372429",
            "country_code": "US",
            "telephone_number": "888-261-1110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHINNAPPAN",
        "first_name": "ARCHANA",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL015563",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01037600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.