Individual provider Active NPI

Jody Mancuso, MA CCC

  • Speech-Language Pathologist
  • Las Vegas, NV
National Provider Identifier
1699120030
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 319 Issued in NV
Practice address
7701 Fall Cliff Rd
Las Vegas, NV 89149-5177
Phone
(702) 524-0953
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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 SP 319 NV Primary

Addresses

Primary practice location

7701 Fall Cliff Rd
Las Vegas, NV 89149-5177

Mailing address

7701 Fall Cliff Rd
Las Vegas, NV 89149-5177
Phone (702) 524-0953

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 Arts

State licenses

LicenseStateTypeSpecialty
SP 319NVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1699120030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 FALL CLIFF RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891495177",
            "telephone_number": "702-524-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 FALL CLIFF RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891495177",
            "telephone_number": "702-524-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "JODY",
        "credential": "MA CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP 319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.