Individual provider Active NPI

Michael Allyson Eades

  • Speech-Language Pathologist
  • Newport News, VA
National Provider Identifier
1225495559
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202008089 Issued in VA
Practice address
12997 Nettles Dr
Newport News, VA 23602-6913
Phone
(757) 249-8880
NPI assigned
Jan 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 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 2202008089 VA Primary

Addresses

Primary practice location

12997 Nettles Dr
Newport News, VA 23602-6913

Mailing address

12997 Nettles Dr
Newport News, VA 23602-6913

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
2202008089VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1225495559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12997 NETTLES DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236026913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12997 NETTLES DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236026913",
            "telephone_number": "757-249-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADES",
        "first_name": "MICHAEL",
        "middle_name": "ALLYSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-18",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; 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.