Active NPI
Maura Elizabeth McKeon
- Speech-Language Pathologist
- Medford, NJ
National Provider Identifier
1245629930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL012287
- Practice address
- 2 Conestoga CT
Medford, NJ 08055-3312 - Phone
- (609) 714-1599
- NPI assigned
- Jan 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL012287 | PA | Primary |
Addresses
Primary practice location
2 Conestoga CT
Medford, NJ 08055-3312
Mailing address
2 Conestoga CT
Medford, NJ 08055-3312
Phone (609) 714-1599
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
| License | State | Type | Specialty |
|---|---|---|---|
| SL012287 | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421539200000",
"number": "1245629930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CONESTOGA CT",
"city": "MEDFORD",
"state": "NJ",
"postal_code": "080553312",
"telephone_number": "609-714-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CONESTOGA CT",
"city": "MEDFORD",
"state": "NJ",
"postal_code": "080553312",
"telephone_number": "609-714-1599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKEON",
"first_name": "MAURA",
"middle_name": "ELIZABETH",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-18",
"last_updated": "2015-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL012287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.