Individual provider Active NPI

Trisha K Klug, MS CCC-SLP

  • Speech-Language Pathologist
  • Martinsburg, WV
National Provider Identifier
1659549657
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12043706 Issued in WV
Practice address
Berkeley County Board of Education
401 South Queen Street
Martinsburg, WV 25401
Phone
(304) 267-3500
NPI assigned
Feb 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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 12043706 WV Primary

Addresses

Primary practice location

Berkeley County Board of Education
401 South Queen Street
Martinsburg, WV 25401

Mailing address

319 Lincoln Dr
Martinsburg, WV 25401-2425
Phone (304) 267-3595

Other identifiers 1

IdentifierTypeStateIssuer
7402032000MedicaidWV

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
12043706WVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1659549657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 LINCOLN DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012425",
            "telephone_number": "304-267-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BERKELEY COUNTY BOARD OF EDUCATION",
            "address_2": "401 SOUTH QUEEN STREET",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-267-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUG",
        "first_name": "TRISHA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "12043706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7402032000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.