NPIMap

Organization Active NPI

Milemarkers Therapy

  • Speech-Language Pathologist
  • Lake Havasu City, AZ
National Provider Identifier
1215487376
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP4317 Issued in AZ
Legal business name
MILEMARKERS THERAPY
Practice address
5601 Highway 95 N Ste 308C5601
Lake Havasu City, AZ 86404-8536
Phone
(928) 854-5439
Fax
(928) 854-5440
NPI assigned
Oct 12, 2016
Organization subpart
Yes
Parent organization
MILEMARKERS THERAPY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Authorized official

Name
Mrs. Colleen McShea, SLP
Title
President-Owner
Phone
(928) 854-5439

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SLP4317 AZ Primary

Addresses

Primary practice location

5601 Highway 95 N Ste 308C5601
Lake Havasu City, AZ 86404-8536

Mailing address

5601 Highway 95 N Ste 308C
Lake Havasu City, AZ 86404-8546
Phone (928) 854-5439

Other identifiers 1

IdentifierTypeStateIssuer
819797MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Milemarkers Therapy Inc2 organizations share this tax ID, including this one
Part of
Milemarkers Therapy Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3090 Highway 95
Bullhead City, AZ 86442
Phone (928) 763-4030

5601 Highway 95 N
Ste 308C5601
Lake Havasu City, AZ 86404
Phone (928) 854-5439

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1215487376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 HIGHWAY 95 N STE 308C",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864048546",
            "telephone_number": "928-854-5439",
            "fax_number": "928-854-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 HIGHWAY 95 N STE 308C5601",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864048536",
            "telephone_number": "928-854-5439",
            "fax_number": "928-854-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILEMARKERS THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILEMARKERS THERAPY INC",
        "enumeration_date": "2016-10-12",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "MCSHEA",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "928-854-5439",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "819797",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.