Individual provider Active NPI

Mary E Neville, SLP

  • Speech-Language Pathologist
  • Londonderry, NH
National Provider Identifier
1245355403
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0467 Issued in NH
Practice address
80 Nashua Rd
BLDG B, Unit 4
Londonderry, NH 03053-0305
Phone
(603) 818-4448
Fax
(603) 818-8704
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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 0467 NH Primary

Addresses

Primary practice location

80 Nashua Rd
BLDG B, Unit 4
Londonderry, NH 03053-0305

Mailing address

5 Isabella Dr
Londonderry, NH 03053-3044
Phone (603) 437-6678

Other practice location 1

5 Isabella Dr
Londonderry, NH 03053-3044
Phone (603) 437-6678

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
0467NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Liz Neville Speech-Language Pathologist Past Accepting new patients
Premier Speech Therapy, LLC Speech-Language Pathologist PastSince Feb 16, 2020 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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1245355403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ISABELLA DR",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533044",
            "telephone_number": "603-437-6678",
            "fax_number": "603-437-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 NASHUA RD",
            "address_2": "BLDG B, UNIT 4",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030530305",
            "telephone_number": "603-818-4448",
            "fax_number": "603-818-8704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Isabella Dr",
            "address_purpose": "LOCATION",
            "city": "Londonderry",
            "state": "NH",
            "postal_code": "030533044",
            "country_code": "US",
            "telephone_number": "603-437-6678",
            "fax_number": "603-437-6678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "0467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Londonderry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.