Active NPI
Emily Douglas
- Speech-Language Pathologist
- Virginia Beach, VA
National Provider Identifier
1609306836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202007692
- Practice address
- 4870 Haygood Rd
Virginia Beach, VA 23455-5300 - Phone
- (757) 499-1290
- NPI assigned
- Jun 20, 2017
- Last updated
- Jun 20, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 2202007692 | VA | Primary |
Addresses
Primary practice location
4870 Haygood Rd
Virginia Beach, VA 23455-5300
Mailing address
4870 Haygood Rd Ste 102
Virginia Beach, VA 23455-5300
Phone (757) 499-1290
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2202007692 | Other | VA | VIRGINIA LICENSE |
| 12097697 | Other | VA | ASHA CERTIFICATION CCC-SLP |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202007692 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497916800000",
"number": "1609306836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4870 HAYGOOD RD STE 102",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234555300",
"telephone_number": "757-499-1290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4870 HAYGOOD RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234555300",
"telephone_number": "757-499-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-20",
"last_updated": "2017-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202007692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA LICENSE",
"identifier": "2202007692",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA CERTIFICATION CCC-SLP",
"identifier": "12097697",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.