Individual provider Active NPI

Marilynn M Monger, MS CCC

  • Speech-Language Pathologist
  • Durango, CO
National Provider Identifier
1689731176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0267382 Issued in CO
Practice address
1291 Oak Drive
Durango, CO 81301-7517
Phone
(970) 247-4052
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0267382 CO Primary

Addresses

Primary practice location

1291 Oak Drive
Durango, CO 81301-7517

Mailing address

1291 Oak Drive
Durango, CO 81301-7517
Phone (970) 247-4052

Other identifiers 1

IdentifierTypeStateIssuer
01185349MedicaidCO

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0267382COMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689731176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 OAK DRIVE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017517",
            "telephone_number": "970-247-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 OAK DRIVE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017517",
            "telephone_number": "970-247-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGER",
        "first_name": "MARILYNN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MS CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0267382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01185349",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.