Mrs Michelle Carol Southerly, SLP is a medicare enrolled "Speech-language Pathologist" provider in Augusta, West Virginia. She graduated from medical school in 1991 and has 34 years of diverse experience with area of expertise as Qualified Speech Language Pathologist. Her current practice location is
Rr 1 Box 34 A, Augusta, West Virginia. You can reach out to her office (for appointments etc.) via phone at
(304) 496-8284.
Mrs Michelle Carol Southerly is licensed to practice in West Virginia (license number 394) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1750407425.
Healthcare Provider's Profile
| Full Name | Mrs Michelle Carol Southerly |
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| Gender | Female |
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| Speciality | Qualified Speech Language Pathologist |
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| Experience | 34 Years |
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| Location | Rr 1 Box 34 A, Augusta, West Virginia |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Michelle Carol Southerly graduated from medical school in 1991
NPI Data:
- NPI Number: 1750407425
- Provider Enumeration Date: 03/22/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0143387225
- Enrollment ID: I20250602001678
Medical Identifiers
Medical identifiers for Mrs Michelle Carol Southerly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1750407425 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | 394 (West Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Michelle Carol Southerly allows following entities to bill medicare on her behalf.
| Provider Name | Powerback Rehabilitation Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1336858398
PECOS PAC ID: 2365359932
Enrollment ID: O20230426003181 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Michelle Carol Southerly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Michelle Carol Southerly, SLP
Rr 1 Box 34 A,
Augusta, WV 26704-9706
Ph: (304) 496-8284 | Mrs Michelle Carol Southerly, SLP
Rr 1 Box 34 A,
Augusta, WV 26704-9706
Ph: (304) 496-8284 |
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