Melinda Kay Thacker

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12886430-4104 Issued in UT

Practice address

415 Medical Dr Ste D101
Bountiful, UT 84010-8905

Phone

(385) 275-0492

NPI assigned

Jul 25, 2022

Last updated

Jul 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Speech Therapy

  • Speech-Language Pathologist
  • Bountiful, UT
  • NPI 1710344973
  NPD (past)

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1689300436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE D101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE D101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108905",
            "telephone_number": "385-275-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "MELINDA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "12886430-4104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.summitlsp.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "415 Medical Dr Ste D101",
            "city": "Bountiful",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840108905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.