Active NPI
McKenzie Childs, CCC-SLP
- Speech-Language Pathologist
- Highland Springs, VA
National Provider Identifier
1972086569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202008910
- Practice address
- 600 Pleasant St
Highland Springs, VA 23075-1221 - Phone
- (509) 637-4902
- NPI assigned
- Sep 11, 2018
- Sex
- Female
- 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 | 2202008910 | VA | Primary |
Addresses
Primary practice location
600 Pleasant St
Highland Springs, VA 23075-1221
Mailing address
1521 Olde Sage CT
Glen Allen, VA 23059-5675
Phone (509) 637-4902
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 |
|---|---|---|---|
| 2202008910 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536624000000",
"number": "1972086569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 OLDE SAGE CT",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230595675",
"telephone_number": "509-637-4902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 PLEASANT ST",
"city": "HIGHLAND SPRINGS",
"state": "VA",
"postal_code": "230751221",
"telephone_number": "509-637-4902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDS",
"first_name": "MCKENZIE",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-11",
"last_updated": "2018-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202008910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Springs, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.