Individual provider Active NPI

Carly Saunders, M.S., CCC/SLP

  • Speech-Language Pathologist
  • Hurricane, WV
National Provider Identifier
1861947103
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
168907 Issued in KY
Practice address
1390 N Poplar Fork Rd
Hurricane, WV 25526-7112
Phone
(304) 757-7826
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 168907 KY Primary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 2075 WV

Addresses

Primary practice location

1390 N Poplar Fork Rd
Hurricane, WV 25526-7112

Mailing address

1390 N Poplar Fork Rd
Hurricane, WV 25526-7112
Phone (304) 757-7856

Other names 1

  • Carly Atkins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830002189 WV Practitioner - Qualified Speech Language Pathologist 6103289723 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
168907KYMDSpeech-Language Pathologist
2075WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Aug 1, 2023 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Aug 1, 2023 Accepting new patients

Locations

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 2

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": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1861947103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 N POPLAR FORK RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255267112",
            "telephone_number": "304-757-7856",
            "fax_number": "606-329-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 N POPLAR FORK RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255267112",
            "telephone_number": "304-757-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "CARLY",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "168907",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "2075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "ATKINS",
            "credential": "M.S., CF-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hurricane, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.

Verify at the official NPI Registry.