Individual provider Active NPI

Carrie Whitt, CCC-SLP

  • Speech-Language Pathologist
  • Leland, MS
National Provider Identifier
1174036792
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S3753 Issued in MS
Practice address
201 Baker Blvd
Leland, MS 38756-3401
Phone
(662) 686-4121
Fax
(662) 686-4770
NPI assigned
Nov 6, 2017
Last updated
Nov 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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 S3753 MS Primary

Addresses

Primary practice location

201 Baker Blvd
Leland, MS 38756-3401

Mailing address

201 Baker Blvd
Leland, MS 38756-3401
Phone (662) 686-4121

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
S3753MSMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1174036792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BAKER BLVD",
            "city": "LELAND",
            "state": "MS",
            "postal_code": "387563401",
            "telephone_number": "662-686-4121",
            "fax_number": "662-686-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BAKER BLVD",
            "city": "LELAND",
            "state": "MS",
            "postal_code": "387563401",
            "telephone_number": "662-686-4121",
            "fax_number": "662-686-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITT",
        "first_name": "CARRIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.