Individual provider Active NPI

Chelsea E Macken

  • Speech-Language Pathologist
  • Fountain Hills, AZ
National Provider Identifier
1487985289
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP6696 Issued in AZ
Practice address
17100 E Shea Blvd
#225
Fountain Hills, AZ 85268-6625
Phone
(480) 837-4565
NPI assigned
Jan 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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 TSLP6696 AZ Primary

Addresses

Primary practice location

17100 E Shea Blvd
#225
Fountain Hills, AZ 85268-6625

Mailing address

13202 W Granada Rd
Goodyear, AZ 85395-3189
Phone (623) 640-5518

Other identifiers 1

IdentifierTypeStateIssuer
1487985289MedicaidAZ

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

LicenseStateTypeSpecialty
TSLP6696AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Achievement Therapy Services Past Accepting new patients
Theraplay4Kidz, LLC Speech-Language Pathologist PastSince Oct 14, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1487985289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13202 W GRANADA RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853953189",
            "telephone_number": "623-640-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 E SHEA BLVD",
            "address_2": "#225",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852686625",
            "telephone_number": "480-837-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEN",
        "first_name": "CHELSEA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP6696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487985289",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.