Individual provider Active NPI

Marcy Noodell, MS-CCC

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1962709006
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
511 Issued in NE
Practice address
3220 South 188 Avenue
Omaha, NE 68130-2804
Phone
(402) 289-9045
NPI assigned
Feb 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 511 NE Primary

Addresses

Primary practice location

3220 South 188 Avenue
Omaha, NE 68130-2804

Mailing address

20650 Glenn St.
Elkhorn, NE 68022-0439
Phone (402) 289-9045

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

State licenses

LicenseStateTypeSpecialty
511NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elkhorn Public Schools CurrentSince Oct 23, 2022 Accepting new patients

Locations

20650 Glenn St
Elkhorn, NE 68022
Phone (402) 289-0616

Organizations & group practices 1

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": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1962709006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20650 GLENN ST.",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680220439",
            "telephone_number": "402-289-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 SOUTH 188 AVENUE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302804",
            "telephone_number": "402-289-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOODELL",
        "first_name": "MARCY",
        "credential": "MS-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-25",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

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