Beth Mutzabaugh

Key facts

NPI

1346721172

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

2202002459 (VA)

Practice address

355 William Mills Dr
Stanardsville, VA 22973-3055

Phone

(434) 985-4434

NPI assigned

Aug 29, 2018

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 29, 2018.

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1346721172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 WILLIAM MILLS DR",
            "city": "STANARDSVILLE",
            "state": "VA",
            "postal_code": "229733055",
            "telephone_number": "434-985-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 WILLIAM MILLS DR",
            "city": "STANARDSVILLE",
            "state": "VA",
            "postal_code": "229733055",
            "telephone_number": "434-985-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTZABAUGH",
        "first_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202002459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Stanardsville, VA · Speech-Language Pathologist in Virginia