Individual provider Active NPI

Mary Kate Keating

  • Speech-Language Pathologist
  • Warren, OH
National Provider Identifier
1912302803
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11574 Issued in OH
Practice address
1543 Tod Ave SW
Warren, OH 44485-4073
Phone
(330) 675-6960
NPI assigned
Nov 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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 11574 OH Primary

Addresses

Primary practice location

1543 Tod Ave SW
Warren, OH 44485-4073

Mailing address

1543 Tod Ave SW
Warren, OH 44485-4073
Phone (330) 675-6960

Other practice location 1

1932 Niles Cortland Rd NE Ste S
Warren, OH 44484-1055
Phone (330) 856-1520

Other identifiers 1

IdentifierTypeStateIssuer
11574OtherOHSPEECH LANGUAGE PATHOLOGIST LICENSE NUMBER

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
11574OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC Speech-Language Pathologist CurrentSince Jun 8, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Sep 18, 2017 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jun 8, 2022 Accepting new patients
Mercy Health Physicians Youngstown, LLC Current Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1932 Niles Cortland Rd NE
Ste S
Warren, OH 44484
Phone (330) 856-1520

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010

Organizations & group practices 5

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": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1912302803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 TOD AVE SW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444854073",
            "telephone_number": "330-675-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 TOD AVE SW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444854073",
            "telephone_number": "330-675-6960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1932 Niles Cortland Rd NE Ste S",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444841055",
            "country_code": "US",
            "telephone_number": "330-856-1520",
            "fax_number": "330-856-7342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEATING",
        "first_name": "MARY KATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "11574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANGUAGE PATHOLOGIST LICENSE NUMBER",
            "identifier": "11574",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.