NPIMap

Organization Active NPI

MDP Speech Language Therapy, PA

  • Speech-Language Pathologist
  • Naples, FL
National Provider Identifier
1962870774
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA4153 Issued in FL
Legal business name
MDP SPEECH LANGUAGE THERAPY, PA
Practice address
6561 Chestnut Cir
Naples, FL 34109-7811
Phone
(239) 248-0458
NPI assigned
Sep 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Marissa PendleyNPI 1144488677
Title
Owner
Phone
(239) 248-0458

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 SA4153 FL Primary

Addresses

Primary practice location

6561 Chestnut Cir
Naples, FL 34109-7811

Mailing address

6561 Chestnut Cir
Naples, FL 34109-7811

Other identifiers 1

IdentifierTypeStateIssuer
599035MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1962870774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6561 CHESTNUT CIR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341097811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6561 CHESTNUT CIR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341097811",
            "telephone_number": "239-248-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDP SPEECH LANGUAGE THERAPY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "PENDLEY",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-248-0458"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA4153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "599035",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.