Individual provider Active NPI

Michele Todtfeld

  • Speech-Language Pathologist
  • Shawnee Mission, KS
National Provider Identifier
1295745123
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1888 Issued in KS
Practice address
10000 W 75TH St Ste 121
Shawnee Mission, KS 66204-2241
Phone
(913) 362-7518
Fax
(913) 362-7302
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 100471 MO
Speech-Language Pathologist 235Z00000X 1888 KS Primary

Addresses

Primary practice location

10000 W 75TH St Ste 121
Shawnee Mission, KS 66204-2241

Mailing address

10000 W 75TH St Ste 121
Shawnee Mission, KS 66204-2241
Phone (913) 362-7518

Other identifiers 1

IdentifierTypeStateIssuer
465062503MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090724000468 MO Practitioner - Qualified Speech Language Pathologist 2668525585 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1888KSMDSpeech-Language Pathologist
100471MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah a King Ma & Associates Inc Speech-Language Pathologist CurrentSince Jul 1, 2009 Accepting new patients

Locations

10000 W 75th St
Ste 121
Shawnee Msn, KS 66204
Phone (913) 362-7518

5301 Harry S Truman Dr
Grandview, MO 64030
Phone (816) 433-4618

Organizations & group practices 1

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1295745123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W 75TH ST STE 121",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662042241",
            "telephone_number": "913-362-7518",
            "fax_number": "913-362-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W 75TH ST STE 121",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662042241",
            "telephone_number": "913-362-7518",
            "fax_number": "913-362-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODTFELD",
        "first_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "100471",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "1888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465062503",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.