Individual provider Active NPI

Christine Macmanus, SLP

  • Speech-Language Pathologist
  • Southbridge, MA
National Provider Identifier
1750566337
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5171 Issued in MA
Practice address
176 Main St
Kennedy Donovan Center
Southbridge, MA 01550-2561
Phone
(508) 765-0292
Fax
(508) 765-0294
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 2133 MA
Speech-Language Pathologist 235Z00000X 5171 MA Primary

Addresses

Primary practice location

176 Main St
Kennedy Donovan Center
Southbridge, MA 01550-2561

Mailing address

176 Main St
Kennedy Donovan Center
Southbridge, MA 01550-2561
Phone (508) 765-0292

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
5171MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1750566337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 MAIN ST",
            "address_2": "KENNEDY DONOVAN CENTER",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502561",
            "telephone_number": "508-765-0292",
            "fax_number": "508-765-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 MAIN ST",
            "address_2": "KENNEDY DONOVAN CENTER",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502561",
            "telephone_number": "508-765-0292",
            "fax_number": "508-765-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACMANUS",
        "first_name": "CHRISTINE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "2133",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "5171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.