Individual provider Active NPI

Tricia Ann Hall Chacchia, MA CCC-SLP

  • Speech-Language Pathologist
  • Mooresville, NC
National Provider Identifier
1265686885
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30002540 Issued in NC
Practice address
199 Blueview Rd
Mooresville, NC 28117-9548
Phone
(914) 584-5750
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 016447 NY
Speech-Language Pathologist 235Z00000X 30002540 NC Primary

Addresses

Primary practice location

199 Blueview Rd
Mooresville, NC 28117-9548

Mailing address

199 Blueview Rd
Mooresville, NC 28117-9548

Other identifiers 2

IdentifierTypeStateIssuer
016447OtherNYNY STATE LICENSE
30002540OtherNCNC STATE LICENSE

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
30002540NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1265686885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 BLUEVIEW RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 BLUEVIEW RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179548",
            "telephone_number": "914-584-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL CHACCHIA",
        "first_name": "TRICIA",
        "middle_name": "ANN",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016447",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30002540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "016447",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "30002540",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.