Individual provider Active NPI

Stephanie Lauren Moran, M.S. SLP-CF

  • Speech-Language Pathologist
  • Saint Louis, MO
National Provider Identifier
1033437512
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2009030850 Issued in MO
Practice address
3625 Magnolia Avenue
Beauvais Manor on the Park
St Louis, MO 63110-4048
Phone
(314) 771-2990
Fax
(341) 771-7790
NPI assigned
May 10, 2010
Last updated
May 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2009030850 MO Primary

Addresses

Primary practice location

3625 Magnolia Avenue
Beauvais Manor on the Park
St Louis, MO 63110-4048

Mailing address

3625 Magnolia Avenue
Beauvais Manor on the Park
St Louis, MO 63110-4048
Phone (314) 771-2990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2009030850MOMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1033437512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MAGNOLIA AVENUE",
            "address_2": "BEAUVAIS MANOR ON THE PARK",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631104048",
            "telephone_number": "314-771-2990",
            "fax_number": "341-771-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MAGNOLIA AVENUE",
            "address_2": "BEAUVAIS MANOR ON THE PARK",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631104048",
            "telephone_number": "314-771-2990",
            "fax_number": "341-771-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "STEPHANIE",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "M.S. SLP-CF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2009030850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.