Individual provider Active NPI

Angela Nicole Howard, SLP

  • Speech-Language Pathologist
  • Iuka, MS
National Provider Identifier
1003111220
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12096621 Issued in MS
Practice address
502 Battleground Dr
Iuka, MS 38852-1311
Phone
(662) 423-2103
Fax
(662) 423-2988
NPI assigned
Jan 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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 12096621 MS Primary

Addresses

Primary practice location

502 Battleground Dr
Iuka, MS 38852-1311

Mailing address

162 County Road 1810
Saltillo, MS 38866-9336
Phone (160) 141-6644

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
12096621MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Care Rehab Past Accepting new patients

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": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1003111220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 COUNTY ROAD 1810",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388669336",
            "telephone_number": "160-141-6644",
            "fax_number": "662-423-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 BATTLEGROUND DR",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521311",
            "telephone_number": "662-423-2103",
            "fax_number": "662-423-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "ANGELA",
        "middle_name": "NICOLE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "12096621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iuka, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.