NPIMap

Individual provider Active NPI

Mackenzie Dierschke

  • Speech-Language Assistant
  • San Angelo, TX
National Provider Identifier
1871072173
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
40613 Issued in TX
Practice address
105 Westland St
San Angelo, TX 76901-3051
Phone
(325) 340-4020
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 40613 TX Primary

Addresses

Primary practice location

105 Westland St
San Angelo, TX 76901-3051

Mailing address

105 Westland St
San Angelo, TX 76901-3051

Other practice location 1

105 Westland St
San Angelo, TX 76901-3051
Phone (325) 340-4020

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reeves Rehab Past Accepting new patients
Reeves Rehab 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1871072173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WESTLAND ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WESTLAND ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013051",
            "telephone_number": "325-340-4020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Westland St",
            "address_purpose": "LOCATION",
            "city": "San Angelo",
            "state": "TX",
            "postal_code": "769013051",
            "country_code": "US",
            "telephone_number": "325-340-4020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIERSCHKE",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "40613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.