Mandy Rebecca Render, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3835 Issued in TN

Practice address

719 Cox Hollow Rd
Kingsport, TN 37663-3152

Phone

(423) 349-0469

NPI assigned

Feb 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1346706975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 COX HOLLOW RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633152",
            "telephone_number": "423-349-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 COX HOLLOW RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633152",
            "telephone_number": "423-349-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDER",
        "first_name": "MANDY",
        "middle_name": "REBECCA",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "3835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.