Individual provider Active NPI

Cheryl Dianne Hawley, MA/CCC/SLP

  • Speech-Language Pathologist
  • Jackson, MS
National Provider Identifier
1093063455
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S3699 Issued in MS
Practice address
4500 I 55 N
Highland Village Ste 291
Jackson, MS 39211-5930
Phone
(601) 362-0859
NPI assigned
Aug 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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 S3699 MS Primary

Addresses

Primary practice location

4500 I 55 N
Highland Village Ste 291
Jackson, MS 39211-5930

Mailing address

240 Greensview Dr
Brandon, MS 39047-7681
Phone (769) 572-5506

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 Arts

State licenses

LicenseStateTypeSpecialty
S3699MSMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1093063455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 GREENSVIEW DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477681",
            "telephone_number": "769-572-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 I 55 N",
            "address_2": "HIGHLAND VILLAGE STE 291",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115930",
            "telephone_number": "601-362-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWLEY",
        "first_name": "CHERYL",
        "middle_name": "DIANNE",
        "name_prefix": "Mrs.",
        "credential": "MA/CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.