Active NPI
Moriah Manchack, CCC-SLP
- Speech-Language Pathologist
- Bryant, AR
National Provider Identifier
1073343364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 202362
- Practice address
- 500 Hill Farm Rd
Bryant, AR 72022-3804 - Phone
- (501) 653-5950
- NPI assigned
- Aug 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 202362 | AR | Primary |
Addresses
Primary practice location
500 Hill Farm Rd
Bryant, AR 72022-3804
Mailing address
10127 Cricket LN
Mabelvale, AR 72103-9391
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202362 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1073343364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10127 CRICKET LN",
"city": "MABELVALE",
"state": "AR",
"postal_code": "721039391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 HILL FARM RD",
"city": "BRYANT",
"state": "AR",
"postal_code": "720223804",
"telephone_number": "501-653-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCHACK",
"first_name": "MORIAH",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-02",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "202362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryant, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.