Individual provider Active NPI

Kerrie L Manthey, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Charlottesville, VA
National Provider Identifier
1508994146
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202004341 Issued in VA
Practice address
3040 Berkmar Dr Ste A1
Charlottesville, VA 22901-1593
Phone
(434) 979-8628
Fax
(434) 979-8536
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 2202004341 VA Primary

Addresses

Primary practice location

3040 Berkmar Dr Ste A1
Charlottesville, VA 22901-1593

Mailing address

3040 Berkmar Dr Ste A1
Charlottesville, VA 22901-1593
Phone (434) 979-8628

Other identifiers 2

IdentifierTypeStateIssuer
227103OtherVASOUTHERN HELATH PROVIDER
4980671MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223002772 VA Practitioner - Qualified Speech Language Pathologist 8022545557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
The Charleston Center, Inc Speech-Language Pathologist CurrentSince Sep 28, 2024 Accepting new patients
Susy Russell Physical Therapy LLC CurrentSince Sep 28, 2024 Accepting new patients

Locations

1102 Rose Hill Dr
Charlottesville, VA 22903
Phone (434) 979-8628

3040 Berkmar Dr
Ste A1
Charlottesvle, VA 22901
Phone (434) 249-9578

200 W 12th St
Bldg I10
Waynesboro, VA 22980
Phone (540) 941-5501

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1508994146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 BERKMAR DR STE A1",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011593",
            "telephone_number": "434-979-8628",
            "fax_number": "434-979-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 BERKMAR DR STE A1",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011593",
            "telephone_number": "434-979-8628",
            "fax_number": "434-979-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTHEY",
        "first_name": "KERRIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HELATH PROVIDER",
            "identifier": "227103",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4980671",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.