Individual provider Active NPI

Mackenzie Moir

  • Speech-Language Pathologist
  • Scott Depot, WV
National Provider Identifier
1336970219
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
6979 Teays Valley Rd
Scott Depot, WV 25560-7097
Phone
(681) 235-7156
Fax
(800) 901-7511
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 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 Primary

Addresses

Primary practice location

6979 Teays Valley Rd
Scott Depot, WV 25560-7097

Mailing address

6979 Teays Valley Rd
Scott Depot, WV 25560-7097
Phone (681) 235-7156

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250918003974 WV Practitioner - Qualified Speech Language Pathologist 0648774919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

803 7TH Ave
Huntington, WV 25701-2117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Developmental Therapy Center, Inc. Speech-Language Pathologist CurrentSince Aug 19, 2025 Accepting new patients
Communication Station, Inc. CurrentSince Aug 18, 2024 Accepting new patients

Locations

803 7th Ave
Huntington, WV 25701
Phone (304) 523-1164

6979 Teays Valley Rd
Scott Depot, WV 25560
Phone (681) 235-7156

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1336970219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 TEAYS VALLEY RD",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255607097",
            "telephone_number": "681-235-7156",
            "fax_number": "800-901-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 TEAYS VALLEY RD",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255607097",
            "telephone_number": "681-235-7156",
            "fax_number": "800-901-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOIR",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott Depot, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.