Active NPI
Moriah Jo Christoffersen
- Speech-Language Pathologist
- Newaygo, MI
National Provider Identifier
1184298200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7151001753
- Practice address
- 585 Fremont St
Newaygo, MI 49337-9766 - Phone
- (231) 652-1638
- NPI assigned
- May 13, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 7151001753 | MI | Primary |
Addresses
Primary practice location
585 Fremont St
Newaygo, MI 49337-9766
Mailing address
917 Snaedle Rd
Whitehall, MI 49461-9147
Phone (231) 349-1293
Other practice location 1
1401 W Main St
Fremont, MI 49412-1486
Phone (231) 924-1788
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7151001753 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1184298200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 SNAEDLE RD",
"city": "WHITEHALL",
"state": "MI",
"postal_code": "494619147",
"telephone_number": "231-349-1293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 FREMONT ST",
"city": "NEWAYGO",
"state": "MI",
"postal_code": "493379766",
"telephone_number": "231-652-1638"
}
],
"practiceLocations": [
{
"address_1": "1401 W Main St",
"address_purpose": "LOCATION",
"city": "Fremont",
"state": "MI",
"postal_code": "494121486",
"country_code": "US",
"telephone_number": "231-924-1788",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHRISTOFFERSEN",
"first_name": "MORIAH",
"middle_name": "JO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-13",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7151001753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newaygo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.