Active NPI
Mary Catherine Moore, M.S. CCC-SLP
- Speech-Language Pathologist
- Greenwood, IN
National Provider Identifier
1184769622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22004174A
- Practice address
- 3000 S State Road 135
Suite 110
Greenwood, IN 46143-9607 - Phone
- (317) 535-4075
- Fax
- (317) 535-4076
- NPI assigned
- Feb 21, 2007
- 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 | 22004174A | IN | Primary |
Addresses
Primary practice location
3000 S State Road 135
Suite 110
Greenwood, IN 46143-9607
Mailing address
1441 Willshire Dr
Greenwood, IN 46143-9098
Phone (317) 859-9696
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22004174A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375660800000",
"number": "1184769622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 WILLSHIRE DR",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461439098",
"telephone_number": "317-859-9696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 S STATE ROAD 135",
"address_2": "SUITE 110",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461439607",
"telephone_number": "317-535-4075",
"fax_number": "317-535-4076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MARY",
"middle_name": "CATHERINE",
"name_prefix": "Mrs.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2013-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22004174A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.