Active NPI
Kortney Leeann Scoggins
- Speech-Language Pathologist
- Jackson, MO
National Provider Identifier
1104644244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2024039289
- Practice address
- 1502 W Jackson Blvd
Jackson, MO 63755-3010 - Phone
- (573) 587-2520
- Fax
- (573) 243-3413
- NPI assigned
- Sep 27, 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 | 2024039289 | MO | Primary |
Addresses
Primary practice location
1502 W Jackson Blvd
Jackson, MO 63755-3010
Mailing address
PO Box 361
Jackson, MO 63755-0361
Phone (573) 587-2520
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 |
|---|---|---|---|
| 2024039289 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beginning Concepts LLC. | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Jackson, MO
- NPI 1538226097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1104644244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 361",
"city": "JACKSON",
"state": "MO",
"postal_code": "637550361",
"telephone_number": "573-587-2520",
"fax_number": "573-243-3413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 W JACKSON BLVD",
"city": "JACKSON",
"state": "MO",
"postal_code": "637553010",
"telephone_number": "573-587-2520",
"fax_number": "573-243-3413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOGGINS",
"first_name": "KORTNEY",
"middle_name": "LEEANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-27",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2024039289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.