Active NPI
Monica Reavis Dudley
- Speech-Language Pathologist
- Midlothian, VA
National Provider Identifier
1942563473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202004397
- Practice address
- 13900 Hull Street Rd
Midlothian, VA 23112-2004 - Phone
- (804) 639-8788
- NPI assigned
- Jun 19, 2012
- 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 | 2202004397 | VA | Primary |
Addresses
Primary practice location
13900 Hull Street Rd
Midlothian, VA 23112-2004
Mailing address
9407 Owl Trace Dr
Chesterfield, VA 23838-8919
Phone (804) 536-3300
Other practice location 1
13900 Hull Street Rd
Midlothian, VA 23112-2004
Phone (804) 639-8788
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202004397 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1942563473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9407 OWL TRACE DR",
"city": "CHESTERFIELD",
"state": "VA",
"postal_code": "238388919",
"telephone_number": "804-536-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13900 HULL STREET RD",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231122004",
"telephone_number": "804-639-8788"
}
],
"practiceLocations": [
{
"address_1": "13900 Hull Street Rd",
"address_purpose": "LOCATION",
"city": "Midlothian",
"state": "VA",
"postal_code": "231122004",
"country_code": "US",
"telephone_number": "804-639-8788",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUDLEY",
"first_name": "MONICA",
"middle_name": "REAVIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-19",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202004397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Midlothian, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.