Active NPI
Megan Russell
- Speech-Language Pathologist
- West Des Moines, IA
National Provider Identifier
1174061162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 002358
- Practice address
- 2913 Elm St
West Des Moines, IA 50265-6221 - Phone
- (515) 971-4588
- NPI assigned
- Feb 9, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 002358 | IA | Primary |
Addresses
Primary practice location
2913 Elm St
West Des Moines, IA 50265-6221
Mailing address
2913 Elm St
West Des Moines, IA 50265-6221
Other practice location 1
709 17th Street
Apt 1
Des Moines, IA 50314
Phone (515) 971-4588
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588550400000",
"number": "1174061162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2913 ELM ST",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502656221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2913 ELM ST",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502656221",
"telephone_number": "515-971-4588"
}
],
"practiceLocations": [
{
"address_1": "709 17th Street",
"address_2": "Apt 1",
"address_purpose": "LOCATION",
"city": "Des Moines",
"state": "IA",
"postal_code": "50314",
"country_code": "US",
"telephone_number": "515-971-4588",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "MEGAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-09",
"last_updated": "2020-05-04",
"certification_date": "2020-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "002358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.