Individual provider Active NPI

Mary E. Faas Mundy

  • Speech-Language Pathologist
  • Fairport, NY
National Provider Identifier
1689960098
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0074861 Issued in NY
Practice address
41 Oconnor Rd
Fairport, NY 14450-1327
Phone
(585) 377-4660
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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 0074861 NY Primary

Addresses

Primary practice location

41 Oconnor Rd
Fairport, NY 14450-1327

Mailing address

41 Oconnor Rd
Fairport, NY 14450-1327
Phone (585) 377-4660

Other names 1

  • Mary E. Faas Mundy Professional name

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

LicenseStateTypeSpecialty
0074861NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1689960098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 OCONNOR RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501327",
            "telephone_number": "585-377-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 OCONNOR RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501327",
            "telephone_number": "585-377-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDY",
        "first_name": "MARY",
        "middle_name": "E. FAAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0074861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MUNDY",
            "middle_name": "E. FAAS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.