Organization Active NPI

Marcimouth Speech and Language Services, Inc.

  • Speech-Language Pathologist
  • Wellington, FL
National Provider Identifier
1871928523
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA7781 Issued in FL
Legal business name
MARCIMOUTH SPEECH AND LANGUAGE SERVICES, INC.
Practice address
12777 Forest Hill Blvd
Suite 1503
Wellington, FL 33414-4775
Phone
(561) 790-1864
Fax
(561) 429-3081
NPI assigned
Sep 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Mrs. Marci Chaves, MS, CCC-SLPNPI 1235198102
Title
Owner/Speech-Language Pathologist
Phone
(561) 790-1864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA7781 FL Primary

Addresses

Primary practice location

12777 Forest Hill Blvd
Suite 1503
Wellington, FL 33414-4775

Mailing address

12777 Forest Hill Blvd
Suite 1503
Wellington, FL 33414-4775
Phone (561) 790-1864

Other identifiers 1

IdentifierTypeStateIssuer
891104500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190816000242 FL Part B Supplier - Clinic/Group Practice 0244567089 Receives reassigned benefits from 1 practitioner
Practice locations: Wellington, FL

National Provider Directory

National Provider Directory

Locations

12773 Forest Hill Blvd
Ste 206
Wellington, FL 33414
Phone (561) 790-1864

12777 Forest Hill Blvd
Ste 1503
Wellington, FL 33414
Phone (561) 790-1864

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1871928523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12777 FOREST HILL BLVD",
            "address_2": "SUITE 1503",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144775",
            "telephone_number": "561-790-1864",
            "fax_number": "561-429-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12777 FOREST HILL BLVD",
            "address_2": "SUITE 1503",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144775",
            "telephone_number": "561-790-1864",
            "fax_number": "561-429-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIMOUTH SPEECH AND LANGUAGE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "CHAVES",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "OWNER/SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "561-790-1864",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891104500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.