Active NPI
Pamela L Vaughan, SLP
- Speech-Language Pathologist
- PT Pleasant, WV
National Provider Identifier
1356619100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-1347
- Practice address
- 2520 Valley Dr
PT Pleasant, WV 25550-2031 - Phone
- (304) 675-4340
- Fax
- (304) 675-5893
- NPI assigned
- Dec 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | SLP-1347 | WV | Primary |
Addresses
Primary practice location
2520 Valley Dr
PT Pleasant, WV 25550-2031
Mailing address
2520 Valley Dr
PT Pleasant, WV 25550-2031
Phone (304) 675-4340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 550440086 | Other | WV | TAX IDENTIFICATION |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-1347 | WV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1356619100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 VALLEY DR",
"city": "PT PLEASANT",
"state": "WV",
"postal_code": "255502031",
"telephone_number": "304-675-4340",
"fax_number": "304-675-5893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 VALLEY DR",
"city": "PT PLEASANT",
"state": "WV",
"postal_code": "255502031",
"telephone_number": "304-675-4340",
"fax_number": "304-675-5893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "PAMELA",
"middle_name": "L",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "SLP-1347",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION",
"identifier": "550440086",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in PT Pleasant, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.