Individual provider Active NPI

Michelle Haddox

  • Speech-Language Pathologist
  • Clay, WV
National Provider Identifier
1245418946
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8530 Issued in WV
Practice address
285 Church Street
Clay, WV 25043
Phone
(304) 587-4266
Fax
(304) 587-4181
NPI assigned
Feb 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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 8530 WV Primary

Addresses

Primary practice location

285 Church Street
Clay, WV 25043

Mailing address

501 22ND St
Dunbar, WV 25064-1711
Phone (304) 766-7655

Other identifiers 1

IdentifierTypeStateIssuer
3810009957MedicaidWV

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

State licenses

LicenseStateTypeSpecialty
8530WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clay County Schools Past Accepting new patients

Organizations & group practices 1

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1245418946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 22ND ST",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "250641711",
            "telephone_number": "304-766-7655",
            "fax_number": "304-755-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 CHURCH STREET",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "25043",
            "telephone_number": "304-587-4266",
            "fax_number": "304-587-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOX",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "8530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009957",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clay, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.