Individual provider Active NPI

Nicole Carver Laffin

  • Speech-Language Pathologist
  • Bowling Green, KY
National Provider Identifier
1336201979
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP402 Issued in WY
Practice address
718 State St
Bowling Green, KY 42101-2247
Phone
(270) 991-6823
Fax
(270) 935-5090
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 SP402 WY Primary

Addresses

Primary practice location

718 State St
Bowling Green, KY 42101-2247

Mailing address

1402 Sherwood Dr
Bowling Green, KY 42103-1434
Phone (270) 991-6823

Other identifiers 2

IdentifierTypeStateIssuer
1336201979OtherKYBCBS KY
314002OtherWYBLUE CROSS BLUE SHIELD WY

Other names 1

  • Nicole Carver Former name

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
SP402WYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336201979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 SHERWOOD DR",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421031434",
            "telephone_number": "270-991-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 STATE ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012247",
            "telephone_number": "270-991-6823",
            "fax_number": "270-935-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFFIN",
        "first_name": "NICOLE",
        "middle_name": "CARVER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WY",
            "license": "SP402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KY",
            "identifier": "1336201979",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD WY",
            "identifier": "314002",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "CARVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.