Active NPI
Mardi Tarbet McKenney
- Speech-Language Pathologist
- Lewisville, TX
National Provider Identifier
1528796257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18245
- Practice address
- 1565 W Main St
Lewisville, TX 75067-3394 - Phone
- (972) 350-4528
- NPI assigned
- Aug 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 18245 | TX | Primary |
Addresses
Primary practice location
1565 W Main St
Lewisville, TX 75067-3394
Mailing address
621 Camilla LN
Lantana, TX 76226-6457
Phone (940) 300-1189
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 |
|---|---|---|---|
| 18245 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1528796257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 CAMILLA LN",
"city": "LANTANA",
"state": "TX",
"postal_code": "762266457",
"telephone_number": "940-300-1189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1565 W MAIN ST",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673394",
"telephone_number": "972-350-4528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNEY",
"first_name": "MARDI",
"middle_name": "TARBET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-10",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "18245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.