Active NPI
Angela Dawn Nuckols, MA
- Speech-Language Pathologist
- Martinsburg, WV
National Provider Identifier
1811160633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 401 S Queen St
Martinsburg, WV 25401-3233 - Phone
- (304) 264-5055
- NPI assigned
- Apr 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | WV | Primary |
Addresses
Primary practice location
401 S Queen St
Martinsburg, WV 25401-3233
Mailing address
62 Paynes Ford Rd
Martinsburg, WV 25405-5799
Phone (304) 262-1576
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7403022000 | Medicaid | WV |
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 Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207958400000",
"number": "1811160633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 PAYNES FORD RD",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254055799",
"telephone_number": "304-262-1576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S QUEEN ST",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254013233",
"telephone_number": "304-264-5055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUCKOLS",
"first_name": "ANGELA",
"middle_name": "DAWN",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-12",
"last_updated": "2008-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7403022000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
- Victoria Lynn Norris, LCPC
- North End Pharmacy
- Novella Women's Health PLLC (Novella Women's Health)
- Novus Healthcare, Inc.
- Theresa A Nuccio-Youngs, PT
- Nurture and Balance PLLC (Nurture and Balance)
- Amanda Louise Nusbaum, RN
- Samantha C Nutter, RPH
- Chukwunonyerem Charlene Nwaneri, PHARM.D
- Ginger Mortimer O'Connell
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.