Individual provider Active NPI

Marguerite Leigh Warner, M.ED, CCC-SLP

  • Speech-Language Pathologist
  • Charlottesville, VA
National Provider Identifier
1114266087
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006919 Issued in VA
Practice address
1281 Swan Lake Dr
#208
Charlottesville, VA 22902-8215
Phone
(434) 979-8628
Fax
(434) 979-8536
NPI assigned
Feb 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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 2202006919 VA Primary

Addresses

Primary practice location

1281 Swan Lake Dr
#208
Charlottesville, VA 22902-8215

Mailing address

609 Kelly Ave
Charlottesville, VA 22902-4709
Phone (434) 979-8628

Other identifiers 1

IdentifierTypeStateIssuer
4980671MedicaidVA

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 Education

State licenses

LicenseStateTypeSpecialty
2202006919VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Susy Russell Physical Therapy LLC PastSince Mar 1, 2012 Accepting new patients
The Charleston Center, Inc Speech-Language Pathologist PastSince Sep 28, 2024 Accepting new patients

Organizations & group practices 2

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": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1114266087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 KELLY AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024709",
            "telephone_number": "434-979-8628",
            "fax_number": "434-979-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 SWAN LAKE DR",
            "address_2": "#208",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229028215",
            "telephone_number": "434-979-8628",
            "fax_number": "434-979-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "MARGUERITE",
        "middle_name": "LEIGH",
        "credential": "M.ED, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-12",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4980671",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.