Jordan Mezzanotte, M.S. CCC-SLP
NPI 1114862471ActiveIndividual· Speech-Language Pathologist· Fairmont, WV
Speech-Language Pathologist (M.S. CCC-SLP) in Fairmont, West Virginia, licensed in WV, with an NPI issued in April 2026. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1114862471 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.S. CCC-SLP |
| Sole proprietor | No |
| NPI issued | Apr 22, 2026 |
| Last updated in NPPES | Apr 22, 2026 |
| Certified by provider | Apr 22, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | SLP-2631 | WV |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (WV) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
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All 46 speech-language pathologists in Fairmont · All speech-language pathologists in West Virginia