Individual provider Active NPI

Vicki Haddix

  • Speech-Language Pathologist
  • Glen Mills, PA
National Provider Identifier
1215156005
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6408 Issued in MA
Practice address
9 Lacrue Ave
Glen Mills, PA 19342-1062
Phone
(800) 578-7906
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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 6408 MA Primary

Addresses

Primary practice location

9 Lacrue Ave
Glen Mills, PA 19342-1062

Mailing address

PO Box 1000
Dept 128
Memphis, TN 38148-0128
Phone (901) 821-0338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229001060 TN Practitioner - Qualified Speech Language Pathologist 8820393838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The University of MemphisGroup PAC ID 9032373956, 11 clinicians

Practice addresses (Care Compare)

4055 N Park Loop
Suite 1004
Memphis, TN 38152-4220
Phone (901) 678-2009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6408MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. CurrentSince Nov 1, 2016 Accepting new patients

Locations

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

4055 N Park Loop
Memphis, TN 38152
Phone (901) 678-2003

4055 N Park Loop
Ste 1004
Memphis, TN 38152
Phone (901) 678-2009

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1215156005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "DEPT 128",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480128",
            "telephone_number": "901-821-0338",
            "fax_number": "901-821-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 LACRUE AVE",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421062",
            "telephone_number": "800-578-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDIX",
        "first_name": "VICKI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "6408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Mills, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.