Individual provider Active NPI

Nancy Johnson Moses, SPEECH LANGUAGE PATH

  • Speech-Language Pathologist
  • Daytona Beach, FL
National Provider Identifier
1205956943
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA541 Issued in FL
Practice address
1104 Beville Road
Suite J
Daytona Beach, FL 32114
Phone
(386) 252-7837
Fax
(386) 252-0021
NPI assigned
Mar 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA541 FL Primary

Addresses

Primary practice location

1104 Beville Road
Suite J
Daytona Beach, FL 32114

Mailing address

1104 Beville Road
Suite J
Daytona Beach, FL 32114-5765
Phone (386) 252-7837

Other identifiers 1

IdentifierTypeStateIssuer
Y7418OtherBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
SA541FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Therapy Services of Florida Inc Past Accepting new patients
First Step Therapeutics Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205956943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 BEVILLE ROAD",
            "address_2": "SUITE J",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145765",
            "telephone_number": "386-252-7837",
            "fax_number": "386-252-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 BEVILLE ROAD",
            "address_2": "SUITE J",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-252-7837",
            "fax_number": "386-252-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "NANCY",
        "middle_name": "JOHNSON",
        "name_prefix": "Ms.",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y7418",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.