Individual provider Active NPI

Marena Mitchell, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Merriam, KS
National Provider Identifier
1942542972
Registry record updated Mar 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2770 Issued in KS
Practice address
5634 Hadley St
Merriam, KS 66202-2158
Phone
(913) 754-6643
NPI assigned
Mar 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2013

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 2770 KS Primary

Addresses

Primary practice location

5634 Hadley St
Merriam, KS 66202-2158

Mailing address

5634 Hadley St
Merriam, KS 66202-2158
Phone (913) 754-6643

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2770KSMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1363392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363392000000",
    "number": "1942542972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5634 HADLEY ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662022158",
            "telephone_number": "913-754-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5634 HADLEY ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662022158",
            "telephone_number": "913-754-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARENA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-16",
        "last_updated": "2013-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merriam, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2013; 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.