Elly Bangert

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2023028425 Issued in MO

Practice address

1552 Country Club Plaza Dr Unit 1570
Saint Charles, MO 63303-3859

Phone

(636) 724-1127

NPI assigned

Aug 7, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988
  NPD (past)

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1194408260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4649 CHIPPEWA WAY",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633047339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COUNTRY CLUB PLAZA DR UNIT 1570",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033859",
            "telephone_number": "636-724-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGERT",
        "first_name": "ELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2023028425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madaleine Olivia Baker, PLPC
• Stacy Jefferson Baker, M.D.
• Bamarek LLC
• Ayotunde Mark Bamimore, M.D
• Krista Emaly Banda, PLPC
• Heather E Baniak, PT
• Ashley Bankston
• Gregg Bantrup, M.D.
• Lisa Margaret Baragiola, RDN, LD
• Barinholtz Chiropractic, LLC

• Speech-Language Pathologist in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.