Individual provider Active NPI

Angela Rachelle Barnes, M.S. CCC/SLP

  • Speech-Language Pathologist
  • Ridgeley, WV
National Provider Identifier
1972604833
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-0979 Issued in WV
Practice address
11 Hunt Club PLZ Ste 102
Ridgeley, WV 26753-5213
Phone
(304) 738-2366
Fax
(304) 738-2210
NPI assigned
Sep 25, 2006
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP-0979 WV Primary
Speech-Language Pathologist 235Z00000X 05102 MD
Speech-Language Pathologist 235Z00000X 2202004847 VA

Addresses

Primary practice location

11 Hunt Club PLZ Ste 102
Ridgeley, WV 26753-5213

Mailing address

11 Hunt Club PLZ Ste 102
Ridgeley, WV 26753-5213
Phone (304) 738-2366

Other identifiers 5

IdentifierTypeStateIssuer
11ZT AROtherMDSPEECH THERAPY
2609907OtherWVSPEECH THERAPY
410592300MedicaidMD
001840673OtherWVSPEECH THERAPY
3810005993MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140115001521 WV Practitioner - Qualified Speech Language Pathologist 7214165422 Practice locations: Ridgeley, WV

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Hunt Club PLZ
Suite 102
Ridgeley, WV 26753-5213
Phone (304) 738-2366

29 Hunt Club PLZ
Ridgeley, WV 26753-5213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
05102MDMDClinical Psychologist
2202004847VAMDSpeech-Language Pathologist
SLP-0979WVMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1972604833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HUNT CLUB PLZ STE 102",
            "city": "RIDGELEY",
            "state": "WV",
            "postal_code": "267535213",
            "telephone_number": "304-738-2366",
            "fax_number": "304-738-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HUNT CLUB PLZ STE 102",
            "city": "RIDGELEY",
            "state": "WV",
            "postal_code": "267535213",
            "telephone_number": "304-738-2366",
            "fax_number": "304-738-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "ANGELA",
        "middle_name": "RACHELLE",
        "credential": "M.S. CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-0979",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05102",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004847",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH THERAPY",
            "identifier": "11ZT AR",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH THERAPY",
            "identifier": "2609907",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410592300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH THERAPY",
            "identifier": "001840673",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005993",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.