Individual provider Active NPI

Margaret K Jetty, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1265749048
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP6968 Issued in AZ
Practice address
1350 S 11TH St
Phoenix, AZ 85034-4537
Phone
(602) 452-6943
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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 SLP6968 AZ Primary

Addresses

Primary practice location

1350 S 11TH St
Phoenix, AZ 85034-4537

Mailing address

1350 S 11TH St
Phoenix, AZ 85034-4537
Phone (480) 286-8720

Other names 1

  • Maggie K Jetty Professional name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP6968AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1265749048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S 11TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850344537",
            "telephone_number": "480-286-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S 11TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850344537",
            "telephone_number": "602-452-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTY",
        "first_name": "MARGARET",
        "middle_name": "K",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP6968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGGIE",
            "last_name": "JETTY",
            "middle_name": "K",
            "credential": "M.S., CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.