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

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: August 02, 2026.

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
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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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

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.

General Practice
401 GUFFEY ST, JOHN MANCHIN SR. HEALTH CARE CENTER
FAIRMONT, WV 26554
Skilled Nursing Facility
401 GUFFEY ST
FAIRMONT, WV 26554

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.

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 3 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.