JORDAN MEZZANOTTE M.S. CCC-SLP
NPI 1114862471
Speech-Language Pathologist in Fairmont, WV

Q: What is Jordan Mezzanotte's NPI number?

The NPI number for Jordan Mezzanotte is 1114862471. It was assigned to this individual provider in the NPPES registry on April 22, 2026.

Q: What is Jordan Mezzanotte's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Mezzanotte was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 22, 2026

401 GUFFEY ST, FAIRMONT, WV 26554(304) 363-2500 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Jordan Mezzanotte M.s. Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN MEZZANOTTE M.S. CCC-SLP (NPI 1114862471) is an individual speech-language pathologist provider in Fairmont, West Virginia, licensed in West Virginia (SLP-2631) and active in the NPI registry since April 2026. She is a graduate of Other (2024).

NPPES Registry Identity

NPI1114862471

Entity TypeIndividualFemale

Primary Taxonomy235Z00000X

Provider Legal NameJORDAN MEZZANOTTECredential: M.S. CCC-SLP

Location Address401 GUFFEY STFairmont, WV 26554-4029

Mailing Address115 Frisco LnBridgeport, WV 26330-5601

Phone(304) 363-2500

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateApril 22, 2026

NPPES CertifiedApril 22, 2026

✔ NPI 1114862471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers

Taxonomy Code235Z00000X

License✔ Licensed in WV · SLP-2631

Definition

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.

401 GUFFEY ST, Fairmont, WV 26554

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Mezzanotte M.s. Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678043825

PECOS Enrollment IDI20260528002869

Medicare Billing Reassignment

Medicare enrollment records show Jordan Mezzanotte reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wv Therapy Services LLC

15 mi

Specialist

306 W MAIN ST
Bridgeport, WV 26330

Reassigned Medicare billing, West Virginia enrollment
40 clinicians in this Medicare group

NPI 1063692333 (304) 842-9887

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMES NAMSUPAK M.D.

General Practice

401 GUFFEY ST, JOHN MANCHIN SR. HEALTH CARE CENTER
FAIRMONT, WV 26554

Marion County (304) 363-2500

MANCHIN WVA FACILITY OPERATIONS LLC

Skilled Nursing Facility

401 GUFFEY ST
FAIRMONT, WV 26554

Marion County (304) 363-2500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Mezzanotte's NPI number?

The NPI number for Jordan Mezzanotte is 1114862471. It was assigned to this individual provider in the NPPES registry on April 22, 2026.

Where is Jordan Mezzanotte located?

Jordan Mezzanotte practices at 401 Guffey St, Fairmont, WV 26554. The listed phone number is (304) 363-2500.

What is Jordan Mezzanotte's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Jordan Mezzanotte enrolled in Medicare?

Yes. Jordan Mezzanotte is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jordan Mezzanotte's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Mezzanotte reassigns Medicare benefits to Wv Therapy Services LLC (Bridgeport, WV). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jordan Mezzanotte's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jordan Mezzanotte was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.