NPIMap

Organization Active NPI

Western Kentucky University Speech Clinic

  • Rehabilitation Clinic/Center
  • Bowling Green, KY
National Provider Identifier
1144636986
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
WESTERN KENTUCKY UNIVERSITY SPEECH CLINIC
Practice address
104 Alumni Ave
Bowling Green, KY 42101-3404
Phone
(270) 745-4232
Fax
(270) 745-4233
NPI assigned
Jul 1, 2014
Organization subpart
Yes
Parent organization
WESTERN KENTUCKY UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Dr. Mary Lloyd Moore, ED.D., CCC-SLP
Title
Director
Phone
(270) 745-2183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

104 Alumni Ave
Bowling Green, KY 42101-3404

Mailing address

104 Alumni Ave
Bowling Green, KY 42101-3404
Phone (270) 745-4232

Other names 1

  • WKU Communication Disorders Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Western Kentucky University5 organizations share this tax ID, including this one
Part of
Western Kentucky University

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

104 Alumni Ave
Bowling Green, KY 42101
Phone (270) 745-4232

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": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1144636986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALUMNI AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421013404",
            "telephone_number": "270-745-4232",
            "fax_number": "270-745-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ALUMNI AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421013404",
            "telephone_number": "270-745-4232",
            "fax_number": "270-745-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN KENTUCKY UNIVERSITY SPEECH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN KENTUCKY UNIVERSITY",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "270-745-2183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WKU Communication Disorders Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.