Mary West

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA3573 Issued in FL

Legal business name

MARY WEST

Practice address

1432 Heather Court
St. Augustine, FL 32092

Phone

(904) 540-8408

Fax

(904) 797-1627

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary B West, MS , CCC-SLP

Title

Owner

Phone

(904) 540-8408

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537488000000",
    "number": "1871644427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 HEATHER COURT",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-540-8408",
            "fax_number": "904-797-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 HEATHER COURT",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-540-8408",
            "fax_number": "904-797-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2018-09-21",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-540-8408",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS , CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA3573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "883173400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Martyn
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• Nino Maruashvili
• Margaret Marutov, DPT
• Mary Alston Kerllenevich, LLC
• Anna Marzak
• Miguel A Mas Jr., MD
• Mason H Long MD PA
• Caitlin Mason, SLP
• Lisa Ann Mason, LMHC

• Speech-Language Pathologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.