Active NPI
Mary Jane Kellogg
- Speech-Language Assistant
- Harlingen, TX
National Provider Identifier
1497980783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 33375
- Practice address
- 2117 E Tyler Ave
Suite B
Harlingen, TX 78550-7211 - Phone
- (956) 440-0580
- Fax
- (956) 440-0584
- NPI assigned
- May 15, 2009
- 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 Assistant | 2355S0801X | 33375 | TX | Primary |
Addresses
Primary practice location
2117 E Tyler Ave
Suite B
Harlingen, TX 78550-7211
Mailing address
2117 E Tyler Ave
Suite B
Harlingen, TX 78550-7211
Phone (956) 440-0580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33375 | Other | TX | STATE LICENSE |
Other names 1
- Mary Jane Cavazos
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 |
|---|---|---|---|
| 33375 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242345600000",
"number": "1497980783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2117 E TYLER AVE",
"address_2": "SUITE B",
"city": "HARLINGEN",
"state": "TX",
"postal_code": "785507211",
"telephone_number": "956-440-0580",
"fax_number": "956-440-0584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2117 E TYLER AVE",
"address_2": "SUITE B",
"city": "HARLINGEN",
"state": "TX",
"postal_code": "785507211",
"telephone_number": "956-440-0580",
"fax_number": "956-440-0584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLOGG",
"first_name": "MARY JANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-15",
"last_updated": "2009-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "33375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "33375",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY JANE",
"last_name": "CAVAZOS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Harlingen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.