Individual provider Active NPI

Caitlin McAuliffe Nusser Mannino, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Waltham, MA
National Provider Identifier
1306260559
Registry record updated Feb 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7478 Issued in MA
Practice address
260 Bear Hill Rd
Suite 105
Waltham, MA 02451-1000
Phone
(617) 834-1565
NPI assigned
Feb 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2014

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 7478 MA Primary

Addresses

Primary practice location

260 Bear Hill Rd
Suite 105
Waltham, MA 02451-1000

Mailing address

54 Slade St
Belmont, MA 02478-2228
Phone (617) 834-1565

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
7478MAMDHealth Service Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1391817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391817600000",
    "number": "1306260559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 SLADE ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024782228",
            "telephone_number": "617-834-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 BEAR HILL RD",
            "address_2": "SUITE 105",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511000",
            "telephone_number": "617-834-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "CAITLIN",
        "middle_name": "MCAULIFFE NUSSER",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-08",
        "last_updated": "2014-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "7478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2014; 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.