Individual provider Active NPI

Martha McManamy, MS CCC-SLP

  • Speech-Language Pathologist
  • Providence, RI
National Provider Identifier
1689110397
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP01510 Issued in RI
Practice address
315 Olney St
FRNT
Providence, RI 02906-2325
Phone
(978) 314-7453
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 76696-SP-SL MA
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X SP01510 RI Primary

Addresses

Primary practice location

315 Olney St
FRNT
Providence, RI 02906-2325

Mailing address

315 Olney St
Providence, RI 02906-2325
Phone (978) 314-7453

Other practice location 1

210 High St
Newburyport, MA 01950-3825
Phone (978) 255-3559

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
76696-SP-SLMAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1689110397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 OLNEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062325",
            "telephone_number": "978-314-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 OLNEY ST",
            "address_2": "FRNT",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062325",
            "telephone_number": "978-314-7453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 High St",
            "address_purpose": "LOCATION",
            "city": "Newburyport",
            "state": "MA",
            "postal_code": "019503825",
            "country_code": "US",
            "telephone_number": "978-255-3559",
            "fax_number": "978-463-3259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMANAMY",
        "first_name": "MARTHA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "76696-SP-SL",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "RI",
            "license": "SP01510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.