Individual provider Active NPI

Marie Mark, CCC-SLP

  • Speech-Language Pathologist
  • Bensalem, PA
National Provider Identifier
1174776231
Registry record updated Nov 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL001211L Issued in PA
Practice address
2606 Marion Ave
Bensalem, PA 19020-4136
Phone
(267) 994-0121
Fax
(215) 638-0922
NPI assigned
Nov 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2008

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 SL001211L PA Primary

Addresses

Primary practice location

2606 Marion Ave
Bensalem, PA 19020-4136

Mailing address

2606 Marion Ave
Bensalem, PA 19020-4136
Phone (267) 994-0121

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
SL001211LPAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1225584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225584000000",
    "number": "1174776231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 MARION AVE",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204136",
            "telephone_number": "267-994-0121",
            "fax_number": "215-638-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 MARION AVE",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204136",
            "telephone_number": "267-994-0121",
            "fax_number": "215-638-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-02",
        "last_updated": "2008-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL001211L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2008; 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.