MARSHALL UNIVERSITY SPEECH AND HEARING CENTER - NPI NUMBER 1407917271

Summary

Provider Name: MARSHALL UNIVERSITY SPEECH AND HEARING CENTER

NPI Number: 1407917271

Clasification: Speech-Language Pathologist (235Z00000X)

Address:
#1 JOHN MARSHALL DR
MARSHALL UNIVERSITY SPEECH AND HEARING CENTER
HUNTINGTON, WV
ZIP 25755

Phone Number: (304) 696-3641



Detailed Information

MARSHALL UNIVERSITY SPEECH AND HEARING CENTER is a speech-language pathologist in Huntington, WV. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. The assigned NPI number for this provider is 1407917271 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

#1 JOHN MARSHALL DR
MARSHALL UNIVERSITY SPEECH AND HEARING CENTER
HUNTINGTON, WV
ZIP 25755-675
Phone: (304) 696-3641
Fax: (304) 696-2986

The provider's authorized official is Nancy C Heffernan .
The authorized official title is Offfice Billing Manager and has the following contact phone number (304) 696-2986.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 7/8/2007.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 235Z00000X Speech-Language Pathologist Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 4000464000 MEDICAID WV

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1407917271 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name MARSHALL UNIVERSITY SPEECH AND HEARING CENTER The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address #1 JOHN MARSHALL DR The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address MARSHALL UNIVERSITY SPEECH AND HEARING CENTER The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name HUNTINGTON The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name WV The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 257552675 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 3046963641 The telephone number associated with the location address of the provider being identified.
12 Provider Business Practice Location Address Fax Number 3046962986 The fax number associated with the location address of the provider being identified.
13 Provider Enumeration Date 12/13/2006 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 7/8/2007 The date that a record was last updated or changed.
15 Authorized Official Last Name HEFFERNAN The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name NANCY The first name of the authorized official.
17 Authorized Official Middle Name C The middle name of the authorized official.
18 Authorized Official Title or Position OFFFICE BILLING MANAGER The title or position of the authorized official.
19 Authorized Official Telephone Number 3046962986 The 10-position telephone number of the authorized official.
20 Healthcare Provider Taxonomy Code 1 235Z00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 4000464000 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier Type Code 1 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier State 1 WV
25 Authorized Official Name Prefix Text MS.
26 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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