Marilyn West

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S2870 Issued in MS

Practice address

111 Chase St
Byhalia, MS 38611-7395

Phone

(662) 838-3670

Fax

(662) 838-3740

NPI assigned

Dec 15, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Marilyn Tidwell Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Educational Based Services

  dba EBS Early Intervention

  • Early Intervention Provider Agency
  • West Chester, PA
  • NPI 1326092602

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1194054577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHASE ST",
            "city": "BYHALIA",
            "state": "MS",
            "postal_code": "386117395",
            "telephone_number": "662-838-3670",
            "fax_number": "662-838-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CHASE ST",
            "city": "BYHALIA",
            "state": "MS",
            "postal_code": "386117395",
            "telephone_number": "662-838-3670",
            "fax_number": "662-838-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "MARILYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "TIDWELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shannon Marie Taylor, D.M.D.
• The Miss Anne Group
• Dwight Thompson, DSS
• Trinity Mission Health & Rehab of Great Oaks, LLC
• Altamese Walls
• Chrystal Williams-Davis, FNP-BC
• Amy R. Woods, M.D.

• Speech-Language Pathologist in Byhalia, MS
• Providers in Byhalia, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.