Individual provider Active NPI

Misty Rae Meeks, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Evansville, IN
National Provider Identifier
1124296579
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22005339A Issued in IN
Practice address
3701 Bellemeade Ave
Evansville, IN 47714-0137
Phone
(812) 479-1411
NPI assigned
Feb 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 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 22005339A IN Primary

Addresses

Primary practice location

3701 Bellemeade Ave
Evansville, IN 47714-0137

Mailing address

3701 Bellemeade Ave
Evansville, IN 47714-0137
Phone (812) 479-1411

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 Science

State licenses

LicenseStateTypeSpecialty
22005339AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1124296579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 BELLEMEADE AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140137",
            "telephone_number": "812-479-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 BELLEMEADE AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140137",
            "telephone_number": "812-479-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKS",
        "first_name": "MISTY",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005339A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.