Individual provider Active NPI

Marie Claire Chan, SLP

  • Speech-Language Pathologist
  • Quincy, MA
National Provider Identifier
1851451330
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6923 Issued in MA
Practice address
1250 Hancock St
Quincy, MA 02169-4339
Phone
(617) 774-0600
Fax
(617) 774-0211
NPI assigned
Dec 12, 2006
Last updated
Jun 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 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 6923 MA Primary

Addresses

Primary practice location

1250 Hancock St
Quincy, MA 02169-4339

Mailing address

147 Milk St
Provider Enrollment - 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8053

Other identifiers 2

IdentifierTypeStateIssuer
0039869OtherMANEIGHBORHOOD HEALTH
908317OtherMATUFTS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6923MAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1851451330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "address_2": "PROVIDER ENROLLMENT - 9TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806",
            "telephone_number": "617-559-8053",
            "fax_number": "617-421-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694339",
            "telephone_number": "617-774-0600",
            "fax_number": "617-774-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MARIE CLAIRE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "6923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0039869",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "908317",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

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