Active NPI
Irene McDonnell, MA CCC SLP
- Speech-Language Pathologist
- Mooresville, NC
National Provider Identifier
1346495959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12450
- Practice address
- 134 Infield CT
Mooresville, NC 28117 - Phone
- (704) 799-6824
- Fax
- (704) 799-6825
- NPI assigned
- Nov 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12450 | NC | Primary |
Addresses
Primary practice location
134 Infield CT
Mooresville, NC 28117
Mailing address
134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824
Other practice location 1
100 N Park Ave
Rockville Centre, NY 11570-4157
Phone (516) 678-0707
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12450 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infant and Toddler Interventionists | Past | Accepting new patients | |
| Integrative Therapy Concepts | Past | Accepting new patients | |
| Lolly Therapeutics, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Pediatric Occupational Therapist
- Mooresville, NC
- NPI 1508849332
-
- Occupational Therapist
- Mooresville, NC
- NPI 1164847752
Speech-Language Pathologist
-
- Early Intervention Provider Agency
- Rockville Centre, NY
- NPI 1083868327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536710400000",
"number": "1346495959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 INFIELD CT",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281178026",
"telephone_number": "704-799-6824",
"fax_number": "704-799-6825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 INFIELD CT",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "28117",
"telephone_number": "704-799-6824",
"fax_number": "704-799-6825"
}
],
"practiceLocations": [
{
"address_1": "100 N Park Ave",
"address_purpose": "LOCATION",
"city": "Rockville Centre",
"state": "NY",
"postal_code": "115704157",
"country_code": "US",
"telephone_number": "516-678-0707",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCDONNELL",
"first_name": "IRENE",
"name_prefix": "Mrs.",
"credential": "MA CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-24",
"last_updated": "2018-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "12450",
"primary": true
}
],
"identifiers": [],
"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 Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.