Individual provider Active NPI

Cassie Dippold, SLP

  • Speech-Language Pathologist
  • Bridgeport, WV
National Provider Identifier
1306609623
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2498 Issued in WV
Practice address
37 Grande Meadows Dr Ste 102
Bridgeport, WV 26330-9035
Phone
(304) 592-2009
Fax
(304) 592-2004
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 2498 WV Primary

Addresses

Primary practice location

37 Grande Meadows Dr Ste 102
Bridgeport, WV 26330-9035

Mailing address

6000 Hampton Ctr Ste B
Morgantown, WV 26505-1748
Phone (304) 599-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812003116 WV Practitioner - Qualified Speech Language Pathologist 9133667967 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2498WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Services, LLC Speech-Language Pathologist CurrentSince May 29, 2024 Accepting new patients
West Virginia University Hospitals, Inc Past Accepting new patients

Locations

37 Grande Meadows Dr
Ste 102
Bridgeport, WV 26330
Phone (304) 592-2009

6000 Hampton Ctr
Ste B
Morgantown, WV 26505
Phone (304) 599-1500

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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1306609623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 HAMPTON CTR STE B",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051748",
            "telephone_number": "304-599-1500",
            "fax_number": "304-599-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 GRANDE MEADOWS DR STE 102",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309035",
            "telephone_number": "304-592-2009",
            "fax_number": "304-592-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPPOLD",
        "first_name": "CASSIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "2498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.