MISSOURI SPEECH THERAPY (NPI# 1821400474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821400474 |
Entity Type | Organization |
Organization Name | MISSOURI SPEECH THERAPY |
Practice Address |
1009 Hwy B Bolivar MO 65613-8252 |
Mailing Address |
4115 101st Rd Bolivar MO 65613-8608 |
Practice Telephone | 4173266754 |
Mailing Telephone | 4173269464 |
Enumeration Date | 2014-05-29 |
Last Update Date | 2018-12-18 |
Authorized Official Name | MRS. MARY R ETHRIDGE (SPEECH/LANGUAGE PATHOLOGIST) |
Authorized Official Telephone | 4173269464 |
Authorized Official Credential | M.S., CCC-SLP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 235Z00000X | Speech-Language Pathologist | 106670 | MO | Speech, Language and Hearing Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | MEDICAID WAIVER | 1134399710 | 01 |
Street Address |
1009 HWY B |
City | BOLIVAR |
State | MO |
Zip Code | 65613-8252 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134399710 | Mary R. Ethridge | Speech-Language Pathologist | 1009 Hwy B, Bolivar, MO 65613-8252 | 2008-03-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
Find all providers in zip 65613 |
Taxonomy Code | 235Z00000X |
Grouping | Speech, Language and Hearing Service Providers |
Classification | Speech-Language Pathologist |
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. |
Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952915761 | Carol Ehrhardt | Speech-Language Pathologist | 620 E Destin Ln, Bolivar, MO 65613-2253 | 2020-08-31 |
1306361787 | Mackenzie Culver German | Speech-Language Pathologist | 1340 Nuckolls Rd, Bolivar, TN 38008-1406 | 2017-08-07 |
1124484548 | Gabrielle Laux | Speech-Language Pathologist | 8404 French Hill Rd Nw, Bolivar, OH 44612-8413 | 2016-01-14 |
1689058950 | Kyla Van Black | Speech-Language Pathologist | 4586 S 116th Rd, Bolivar, MO 65613-8547 | 2015-07-16 |
1831441146 | Tanya S Willis | Speech-Language Pathologist | 10815 Old Highway 64, Bolivar, TN 38008-3599 | 2012-10-10 |
1902054992 | Angela Renee Baron | Speech-Language Pathologist | 210 Olive St, Bolivar, NY 14715-1324 | 2008-09-03 |
1588820831 | Sheri Kaye Reeves | Speech-Language Pathologist | 1454 E 420th Rd, Bolivar, MO 65613-1197 | 2008-08-05 |
1477687713 | Erin Giglio | Speech-Language Pathologist | 1541 Highway Kk, Bolivar, MO 65613-8446 | 2007-03-16 |
1992837132 | Beth Marie Bernard | Speech-Language Pathologist | 524 W Madison St, Bolivar, MO 65613-1945 | 2007-03-12 |
1992849160 | Wendy M Lueckenhoff | Speech-Language Pathologist | 452 S Springfield Ave, Bolivar, MO 65613-2146 | 2007-02-19 |
Find all providers in BOLIVAR |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.