Active NPI
Michael Carr
- Speech-Language Pathologist
- Charleston, WV
National Provider Identifier
1962670935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4578
- Practice address
- 200 Elizabeth St
Charleston, WV 25311-2119 - Phone
- (304) 348-7740
- Fax
- (304) 348-6671
- NPI assigned
- Feb 13, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 4578 | WV | Primary |
Addresses
Primary practice location
200 Elizabeth St
Charleston, WV 25311-2119
Mailing address
501 22ND St
Dunbar, WV 25064-1711
Phone (304) 766-7655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0153085000 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4578 | WV | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kanawha County Schools | Past | Accepting new patients | |
| Kanawha County Schools | Past | Accepting new patients |
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.
-
- Local Education Agency (LEA)
- Charleston, WV
- NPI 1205035334
-
- Local Education Agency (LEA)
- Charleston, WV
- NPI 1407026636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1962670935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 22ND ST",
"city": "DUNBAR",
"state": "WV",
"postal_code": "250641711",
"telephone_number": "304-766-7655",
"fax_number": "304-755-2824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ELIZABETH ST",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253112119",
"telephone_number": "304-348-7740",
"fax_number": "304-348-6671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-13",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "4578",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0153085000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.