Individual provider Active NPI

Michelle Georgette Knuckley, MSP, CCC-SLP

  • Speech-Language Pathologist
  • Anderson, SC
National Provider Identifier
1659467264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3612 Issued in SC
Practice address
1501 E Greenville St
Anderson, SC 29621-2004
Phone
(864) 226-8356
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3612 SC Primary

Addresses

Primary practice location

1501 E Greenville St
Anderson, SC 29621-2004

Mailing address

437 Walden Creek Way
Greenville, SC 29615-6714
Phone (803) 446-3351

Other identifiers 2

IdentifierTypeStateIssuer
3612OtherSCSTATE LICENSURE
12094682OtherSCASHA CERTIFICATION

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
3612SCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659467264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 WALDEN CREEK WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156714",
            "telephone_number": "803-446-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212004",
            "telephone_number": "864-226-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUCKLEY",
        "first_name": "MICHELLE",
        "middle_name": "GEORGETTE",
        "name_prefix": "Miss",
        "credential": "MSP, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "3612",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA CERTIFICATION",
            "identifier": "12094682",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.