Active NPI
Charlette Brown
- Speech-Language Pathologist
- Hernando, MS
National Provider Identifier
1831531474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP0000003003
- Practice address
- 3130 McIngvale Rd
Hernando, MS 38632-8795 - Phone
- (662) 469-9009
- NPI assigned
- Jul 24, 2013
- Last updated
- Jun 6, 2023
- 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 | SP0000003003 | TN | Primary |
Addresses
Primary practice location
3130 McIngvale Rd
Hernando, MS 38632-8795
Mailing address
3130 McIngvale Rd
Hernando, MS 38632-8795
Other names 1
- Charlette McBride
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP0000003003 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-Vista Rehab, Inc | Current | Accepting new patients | |
| Tri-Vista Rehab, Inc | Speech-Language Pathologist | Current | Accepting new patients |
| Midsouth Therapy Solutions | Past | Accepting new patients | |
| Complete Hospice & Palliative Care | Past | Accepting new patients | |
| Shelby County Board of Education | Past | Accepting new patients |
Locations
90 Clark Blvd
#A
Tupelo, MS 38804
Phone (662) 205-4282
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba TriVista Rehab at Community Development Inc.
- Rehabilitation Clinic/Center
- Richton, MS
- NPI 1265025522
-
- Community Based Hospice Care Agency
- Batesville, MS
- NPI 1497708432
-
- Local Education Agency (LEA)
- Memphis, TN
- NPI 1720496425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1831531474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3130 MCINGVALE RD",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386328795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 MCINGVALE RD",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386328795",
"telephone_number": "662-469-9009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "CHARLETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-24",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "SP0000003003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHARLETTE",
"last_name": "MCBRIDE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hernando, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.