Active NPI
Shepherd Taonezvi Mararike, SPEECH PATHOLOGIST
- Speech-Language Pathologist
- Paxton, MA
National Provider Identifier
1508007246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4963
- Practice address
- 12 Dunanderry Way
Paxton, MA 01612-1528 - Phone
- (508) 795-7053
- NPI assigned
- Mar 10, 2009
- 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 | 4963 | MA | Primary |
Addresses
Primary practice location
12 Dunanderry Way
Paxton, MA 01612-1528
Mailing address
12 Dunanderry Way
Paxton, MA 01612-1528
Phone (508) 795-7053
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 |
|---|---|---|---|
| 4963 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236643200000",
"number": "1508007246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 DUNANDERRY WAY",
"city": "PAXTON",
"state": "MA",
"postal_code": "016121528",
"telephone_number": "508-795-7053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 DUNANDERRY WAY",
"city": "PAXTON",
"state": "MA",
"postal_code": "016121528",
"telephone_number": "508-795-7053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARARIKE",
"first_name": "SHEPHERD",
"middle_name": "TAONEZVI",
"name_prefix": "Dr.",
"credential": "SPEECH PATHOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-10",
"last_updated": "2009-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "4963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paxton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.