Organization Active NPI

Speech Therapy for Kids, LLC

  • Speech-Language Pathologist
  • Starkville, MS
National Provider Identifier
1124356605
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S2545 Issued in MS
Legal business name
SPEECH THERAPY FOR KIDS, LLC
Practice address
501 Highway 12 W Ste a&D
Starkville, MS 39759-3654
Phone
(662) 574-2634
Fax
(662) 338-5439
NPI assigned
Nov 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Mrs. Melissa Long Davis, M.S., CCC-SLP
Title
Owner
Phone
(662) 574-2634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X S2545 MS Primary

Addresses

Primary practice location

501 Highway 12 W Ste a&D
Starkville, MS 39759-3654

Mailing address

923 Live Oak LN
Starkville, MS 39759-8565
Phone (662) 574-2634

Other identifiers 1

IdentifierTypeStateIssuer
07384811MedicaidMS

National Provider Directory

National Provider Directory

Locations

501 Highway 12 W
Ste Ad
Starkville, MS 39759
Phone (662) 574-2634

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1124356605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 LIVE OAK LN",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397598565",
            "telephone_number": "662-574-2634",
            "fax_number": "662-338-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HIGHWAY 12 W STE A&D",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593654",
            "telephone_number": "662-574-2634",
            "fax_number": "662-338-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH THERAPY FOR KIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-23",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "LONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-574-2634",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07384811",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.