Misty Blaylock, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Berea, KY
NPI 1821597006 · NPPES record last updated Feb 2, 2018
Key facts
- NPI
- 1821597006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 138621 (KY)
- Practice address
- 1043 Brooklyn Blvd
Berea, KY 40403-1090 - Phone
- (859) 228-0551
- NPI assigned
- Feb 2, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Empowerme Rehabilitation Kentucky, LLC
Practice addresses (Care Compare)
1165 Monarch St
Lexington, KY 40513-1979
Phone (844) 502-7996
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240320003784 | KY | Practitioner - Qualified Speech Language Pathologist | 8325485709 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowerme Rehabilitation Kentucky, LLC | Current |
Accepting new patients | |
| Empowerme Rehabilitation Kentucky, LLC | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 138621 | KY | Yes |
Addresses
Primary practice location
1043 Brooklyn Blvd
Berea, KY 40403-1090
Mailing address
1013 Cherry CT
Richmond, KY 40475-8902
Other names
- Misty Parrott
Other providers in Berea, KY
- BHG Lviii, LLC
- BHG Lviii, LLC
- BHG XXXV, LLC
- Annie Ruth Bland
- Samantha V Blandford
- Angela Boggs
- Tonya Danielle Booth
- Ladonna Borge
- Gerri Botts
- John C Bowers
All providers in Berea, KY · Speech-Language Pathologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.