Alexis Mayberry, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2024042209 Issued in MO

Practice address

910 Nina St
Dexter, MO 63841-9114

Phone

(573) 624-4669

NPI assigned

Jun 28, 2023

Last updated

Jul 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenny Rogers Children's Center

  • Occupational Therapy Assistant
  • Sikeston, MO
  • NPI 1013026194

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1114604634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3994 COUNTY ROAD 607",
            "city": "BERNIE",
            "state": "MO",
            "postal_code": "638227101",
            "telephone_number": "573-625-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 NINA ST",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638419114",
            "telephone_number": "573-624-4669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Hwy 162",
            "address_purpose": "LOCATION",
            "city": "Clarkton",
            "state": "MO",
            "postal_code": "63837",
            "country_code": "US",
            "telephone_number": "573-448-3773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "ALEXIS",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2024042209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Lovins-Bewley, AGACNP-BC
• Heather L Maddox, PT/DPT
• Stacy Allen Mangum, PHARM.D.
• Marion Eye Centers, LTD.
• Marion Eye Centers, LTD.
• Hillary A Mayberry, LPC
• Kathryn A. Mayberry, O.D.
• Christa Renee McBroom, PHARMD
• Tonya McClain, PNP
• Angela Kaye McGowan, LPC

• Speech-Language Pathologist in Dexter, MO
• Providers in Dexter, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.