Active NPI
Mark Gridley, CCC-SLP
- Speech-Language Pathologist
- Lawrence, KS
National Provider Identifier
1427352707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3110
- Practice address
- 610 Greever Ter
Lawrence, KS 66046-2861 - Phone
- (785) 766-4384
- NPI assigned
- Dec 31, 2010
- Sex
- Male
- 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 | 3110 | KS | Primary |
Addresses
Primary practice location
610 Greever Ter
Lawrence, KS 66046-2861
Mailing address
610 Greever Ter
Lawrence, KS 66046-2861
Phone (785) 766-4384
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293753600000",
"number": "1427352707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 GREEVER TER",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660462861",
"telephone_number": "785-766-4384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 GREEVER TER",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660462861",
"telephone_number": "785-766-4384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIDLEY",
"first_name": "MARK",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-31",
"last_updated": "2010-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "3110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.