Individual provider Active NPI

Haley Nicole Main

  • Speech-Language Pathologist
  • Humboldt, IA
National Provider Identifier
1477190197
Registry record updated Dec 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
096560 Issued in IA
Practice address
800 13TH St S
Humboldt, IA 50548-2439
Phone
(515) 332-4104
NPI assigned
Dec 1, 2019
Last updated
Dec 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2019

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 096560 IA Primary

Addresses

Primary practice location

800 13TH St S
Humboldt, IA 50548-2439

Mailing address

120 N Lincoln Ave
Eagle Grove, IA 50533-1728
Phone (319) 981-2172

Other practice location 1

620 SE 5th St
Eagle Grove, IA 50533-2477
Phone (515) 331-3190

Other practice location 2

1111 11th Ave N
Humboldt, IA 50548-1225
Phone (515) 332-2623

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
096560IAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1575158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575158400000",
    "number": "1477190197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N LINCOLN AVE",
            "city": "EAGLE GROVE",
            "state": "IA",
            "postal_code": "505331728",
            "telephone_number": "319-981-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 13TH ST S",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505482439",
            "telephone_number": "515-332-4104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 SE 5th St",
            "address_purpose": "LOCATION",
            "city": "Eagle Grove",
            "state": "IA",
            "postal_code": "505332477",
            "country_code": "US",
            "telephone_number": "515-331-3190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 11th Ave N",
            "address_purpose": "LOCATION",
            "city": "Humboldt",
            "state": "IA",
            "postal_code": "505481225",
            "country_code": "US",
            "telephone_number": "515-332-2623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAIN",
        "first_name": "HALEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-01",
        "last_updated": "2019-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "096560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humboldt, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2019; 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.