Individual provider Active NPI

Emma Lynn Eickleberry, SLP

  • Speech-Language Pathologist
  • Summersville, WV
National Provider Identifier
1780499673
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-2592 Issued in WV
Practice address
400 Old Main Dr
Summersville, WV 26651-1360
Phone
(304) 872-3611
Fax
(304) 872-4626
NPI assigned
Feb 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 SLP-2592 WV Primary

Addresses

Primary practice location

400 Old Main Dr
Summersville, WV 26651-1360

Mailing address

400 Old Main Dr
Summersville, WV 26651-1360
Phone (304) 872-3611

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
SLP-2592WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas County Board of Education PastSince Feb 23, 2025 Accepting new patients
Hagerstown Home Care Therapy, Inc. Speech-Language Pathologist Past Accepting new patients
Nicholas County Board of Education PastSince Feb 23, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1780499673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 OLD MAIN DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511360",
            "telephone_number": "304-872-3611",
            "fax_number": "304-872-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OLD MAIN DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511360",
            "telephone_number": "304-872-3611",
            "fax_number": "304-872-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICKLEBERRY",
        "first_name": "EMMA",
        "middle_name": "LYNN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-2592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.