Individual provider Active NPI

Carolyn D McIntyre

  • Speech-Language Pathologist
  • PT Pleasant, WV
National Provider Identifier
1508150996
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-0532 Issued in WV
Practice address
2520 Valley Dr
PT Pleasant, WV 25550-2031
Phone
(304) 675-4340
Fax
(304) 675-5893
NPI assigned
Jun 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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 SLP-0532 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

IdentifierTypeStateIssuer
550440086OtherWV550440086

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
SLP-0532WVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1508150996",
    "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": "MCINTYRE",
        "first_name": "CAROLYN",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-0532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "550440086",
            "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 Jun 3, 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.

Verify at the official NPI Registry.