Active NPI
Mary Travnicek
- Speech-Language Pathologist
- Sioux Falls, SD
National Provider Identifier
1366968943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 673-SLP
- Practice address
- 4501 S Holbrook Ave
Sioux Falls, SD 57106-1926 - Phone
- (605) 362-2784
- NPI assigned
- Aug 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 673-SLP | SD | Primary |
Addresses
Primary practice location
4501 S Holbrook Ave
Sioux Falls, SD 57106-1926
Mailing address
1225 S Blauvelt Ave
Sioux Falls, SD 57105-1107
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 673-SLP | SD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502841600000",
"number": "1366968943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 S BLAUVELT AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 S HOLBROOK AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571061926",
"telephone_number": "605-362-2784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVNICEK",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-16",
"last_updated": "2017-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SD",
"license": "673-SLP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.