Individual provider Active NPI

Mary Beth Debevec, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1467536938
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2667 Issued in NM
Practice address
415 Cedar St SE
Albuquerque, NM 87106-3927
Phone
(505) 224-7020
Fax
(505) 224-7023
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 2667 NM Primary

Addresses

Primary practice location

415 Cedar St SE
Albuquerque, NM 87106-3927

Mailing address

10333 Malaguena LN NE
Albuquerque, NM 87111-1720
Phone (505) 323-5770

Other identifiers 1

IdentifierTypeStateIssuer
87487811MedicaidNM

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
2667NMMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467536938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 MALAGUENA LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111720",
            "telephone_number": "505-323-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CEDAR ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871063927",
            "telephone_number": "505-224-7020",
            "fax_number": "505-224-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBEVEC",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "2667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87487811",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.