Active NPI
Marvel Orofacial Myofunctional Therapy
Doing business as MarvelMyo & Speech, PLLC
- Speech-Language Pathologist
- Keller, TX
National Provider Identifier
1336913532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- MARVEL OROFACIAL MYOFUNCTIONAL THERAPY
- Doing business as
- MarvelMyo & Speech, PLLC
- Practice address
- 349 Keller Pkwy
Keller, TX 76248-2266 - Phone
- (469) 900-5448
- NPI assigned
- Nov 8, 2023
- Last updated
- Nov 8, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Katelyn Spencer, CCC-SLP
- Title
- Speech-Language Pathologist, Owner
- Phone
- (469) 900-5448
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | NU | Primary |
Addresses
Primary practice location
349 Keller Pkwy
Keller, TX 76248-2266
Mailing address
349 Keller Pkwy
Keller, TX 76248-2266
Phone (469) 900-5448
Other names 1
- MarvelMyo & Speech, PLLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, VA, NC
Enrollment records 3
National Provider Directory
National Provider DirectoryLocations
349 Keller Pkwy
Keller, TX 76248
Phone (469) 865-8057
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Speech-Language Pathologist
- Amarillo, TX
- NPI 1700498177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699401600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1699401600000",
"number": "1336913532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "349 KELLER PKWY",
"city": "KELLER",
"state": "TX",
"postal_code": "762482266",
"telephone_number": "469-900-5448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349 KELLER PKWY",
"city": "KELLER",
"state": "TX",
"postal_code": "762482266",
"telephone_number": "469-900-5448"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARVEL OROFACIAL MYOFUNCTIONAL THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-08",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A",
"authorized_official_last_name": "SPENCER",
"authorized_official_first_name": "KATELYN",
"authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST, OWNER",
"authorized_official_telephone_number": "469-900-5448",
"authorized_official_credential": "CCC-SLP"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MarvelMyo & Speech, PLLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.