Individual provider Active NPI

Mary Pankratz, M.S., CF-SLP

  • Speech-Language Pathologist
  • Marana, AZ
National Provider Identifier
1700928389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP5159 Issued in AZ
Practice address
11279 W Grier Rd
Musd Special Education Ste 123
Marana, AZ 85653-9609
Phone
(520) 682-4782
Fax
(520) 682-4818
NPI assigned
Feb 12, 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 TSLP5159 AZ Primary

Addresses

Primary practice location

11279 W Grier Rd
Musd Special Education Ste 123
Marana, AZ 85653-9609

Mailing address

11 E Orange Grove Rd
Apt #1111
Tucson, AZ 85704-5559
Phone (520) 579-4564

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
TSLP5159AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700928389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 E ORANGE GROVE RD",
            "address_2": "APT #1111",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045559",
            "telephone_number": "520-579-4564",
            "fax_number": "520-579-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11279 W GRIER RD",
            "address_2": "MUSD SPECIAL EDUCATION STE 123",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856539609",
            "telephone_number": "520-682-4782",
            "fax_number": "520-682-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKRATZ",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "M.S., CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP5159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marana, AZ

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.