Individual provider Active NPI

Cynthia Breid Baker, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mountain Grove, MO
National Provider Identifier
1215009840
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
102290 Issued in MO
Practice address
207 E 5TH St
Mountain Grove, MO 65711-1660
Phone
(417) 926-3177
Fax
(417) 926-3177
NPI assigned
Nov 15, 2006
Last updated
Apr 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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 102290 MO Primary

Addresses

Primary practice location

207 E 5TH St
Mountain Grove, MO 65711-1660

Mailing address

PO Box 806
207 E. 5TH Street
Mountain Grove, MO 65711-0806
Phone (417) 926-3177

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
102290MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Grove R-III School District Past Accepting new patients

Organizations & group practices 1

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271635200000",
    "number": "1215009840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 806",
            "address_2": "207 E. 5TH STREET",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657110806",
            "telephone_number": "417-926-3177",
            "fax_number": "417-926-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E 5TH ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111660",
            "telephone_number": "417-926-3177",
            "fax_number": "417-926-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "CYNTHIA",
        "middle_name": "BREID",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "102290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; 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.