Active NPI
David B Mack, SLP
- Speech-Language Pathologist
- Lenexa, KS
National Provider Identifier
1487927547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1415
- Practice address
- 15055 W 87TH St Parkway
Lenexa, KS 66215 - Phone
- (913) 307-0665
- NPI assigned
- Feb 20, 2012
- 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 | 1415 | KS | Primary |
Addresses
Primary practice location
15055 W 87TH St Parkway
Lenexa, KS 66215
Mailing address
26360 W 111 Terr
Olathe, KS 66061
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329696000000",
"number": "1487927547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26360 W 111 TERR",
"city": "OLATHE",
"state": "KS",
"postal_code": "66061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15055 W 87TH ST PARKWAY",
"city": "LENEXA",
"state": "KS",
"postal_code": "66215",
"telephone_number": "913-307-0665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "DAVID",
"middle_name": "B",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-20",
"last_updated": "2012-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "1415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lenexa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.