Individual provider Active NPI

Ka Cheuk, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mount Vernon, MO
National Provider Identifier
1124693742
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2021018946 Issued in MO
Practice address
1600 S Hickory St
Mount Vernon, MO 65712-2045
Phone
(417) 466-7103
NPI assigned
May 25, 2021
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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 2021018946 MO Primary

Addresses

Primary practice location

1600 S Hickory St
Mount Vernon, MO 65712-2045

Mailing address

1600 S Hickory St
Mount Vernon, MO 65712-2045
Phone (417) 466-7103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211021002837 MO Practitioner - Qualified Speech Language Pathologist 4082002183 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 clinicians
Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

Festus, MO 63028
Phone (610) 925-1176

12399 Gravois Rd
Saint Louis, MO 63127-1736
Phone (337) 310-8500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2021018946MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bel Oak of Hudson House LLC Speech-Language Pathologist Current Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Mar 13, 2025 Accepting new patients
Bel Oak of Hudson House LLC Speech-Language Pathologist CurrentSince Feb 1, 2025 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Mar 13, 2025 Accepting new patients
Bel Oak of Hudson House, LLC Speech-Language Pathologist CurrentSince Feb 1, 2025 Accepting new patients

Locations

1700B S Hudson Ave
Aurora, MO 65605
Phone (417) 678-2169

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1124693742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S HICKORY ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657122045",
            "telephone_number": "417-466-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S HICKORY ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657122045",
            "telephone_number": "417-466-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEUK",
        "first_name": "KA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2021018946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.