Active NPI
Marta A Doe, M.A. CCC-SLP
- Speech-Language Pathologist
- Irving, TX
National Provider Identifier
1629234877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL60025574
- Practice address
- 5001 Statesman Dr
Irving, TX 75063-2414 - Phone
- (877) 282-5613
- Fax
- (877) 508-1628
- NPI assigned
- Aug 6, 2008
- 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 Pathologist | 235Z00000X | LL60025574 | WA | Primary |
Addresses
Primary practice location
5001 Statesman Dr
Irving, TX 75063-2414
Mailing address
1608 W Plath Ave
#2
Yakima, WA 98902-5249
Phone (509) 945-6005
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7980709 | Medicaid | WA | |
| 506506 | Other | WA | MEDICARE SPEECH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL60025574 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405987200000",
"number": "1629234877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1608 W PLATH AVE",
"address_2": "#2",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989025249",
"telephone_number": "509-945-6005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 STATESMAN DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750632414",
"telephone_number": "877-282-5613",
"fax_number": "877-508-1628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOE",
"first_name": "MARTA",
"middle_name": "A",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-06",
"last_updated": "2014-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL60025574",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7980709",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE SPEECH",
"identifier": "506506",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.