Active NPI
Mackenzie Dalton
- Speech-Language Pathologist
- Weatherford, TX
National Provider Identifier
1861013971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 115565
- Practice address
- 1429 Clear Lake Rd Ste 200
Weatherford, TX 76086-8801 - Phone
- (682) 231-1720
- NPI assigned
- Apr 29, 2020
- Last updated
- Apr 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 115565 | TX | Primary |
Addresses
Primary practice location
1429 Clear Lake Rd Ste 200
Weatherford, TX 76086-8801
Mailing address
8101 Boat Club Rd Ste 160
Fort Worth, TX 76179-3631
Phone (682) 231-1720
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
| License | State | Type | Specialty |
|---|---|---|---|
| 115565 | TX | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tadpoles Pediatric Therapy | Speech-Language Pathologist | Past | Accepting new patients |
| Talking Tadpoles, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Speech-Language Pathologist
- Fort Worth, TX
- NPI 1518490762
-
- Speech-Language Pathologist
- Saginaw, TX
- NPI 1790143113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588118400000",
"number": "1861013971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8101 BOAT CLUB RD STE 160",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761793631",
"telephone_number": "682-231-1720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1429 CLEAR LAKE RD STE 200",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760868801",
"telephone_number": "682-231-1720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALTON",
"first_name": "MACKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-29",
"last_updated": "2020-04-29",
"certification_date": "2020-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "115565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.