Individual provider Active NPI

Beverly Cannarella

  • Speech-Language Pathologist
  • Hartsville, SC
National Provider Identifier
1710114913
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
291 Issued in SC
Practice address
205 Fairfield Ter
Hartsville, SC 29550-3221
Phone
(843) 332-7953
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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 291 SC Primary

Addresses

Primary practice location

205 Fairfield Ter
Hartsville, SC 29550-3221

Mailing address

205 Fairfield Ter
Hartsville, SC 29550-3221
Phone (843) 332-7953

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

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1710114913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 FAIRFIELD TER",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295503221",
            "telephone_number": "843-332-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 FAIRFIELD TER",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295503221",
            "telephone_number": "843-332-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNARELLA",
        "first_name": "BEVERLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.