Macy Carmack
Individual provider Active NPI Speech-Language Pathologist · Gate City, VA
NPI 1760165252 · NPPES record last updated Aug 10, 2023
Key facts
- NPI
- 1760165252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2204001218 (VA)
- Practice address
- 218 Shoemaker Dr
Gate City, VA 24251-2700 - Phone
- (276) 386-7002
- NPI assigned
- Aug 10, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2204001218 | VA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2204001218 | VA | Yes |
Addresses
Primary practice location
218 Shoemaker Dr
Gate City, VA 24251-2700
Mailing address
1033 Allandale Cir
Kingsport, TN 37660-9002
Phone (423) 765-6037
Other providers in Gate City, VA
- Anna Joyce Byrd
- Danielle Leeann Calhoun
- Hayley Elise Campbell
- Melissa Marie Cantor
- Mollie Capone
- Alysen M Carter
- Teresa Lynn Castle
- Wray West Chaffin II
- Trevor Chow
- Courtney Cline
All providers in Gate City, VA · Speech-Language Pathologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.