Individual provider Active NPI

Mary Katherine Moncure, M.S. CF-SLP

  • Speech-Language Pathologist
  • Lynchburg, VA
National Provider Identifier
1215777396
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202011915 Issued in VA
Practice address
1912 Memorial Ave
Lynchburg, VA 24501-1708
Phone
(434) 845-8765
Fax
(434) 845-8467
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2204001373 VA
Speech-Language Pathologist 235Z00000X 2202011915 VA Primary

Addresses

Primary practice location

1912 Memorial Ave
Lynchburg, VA 24501-1708

Mailing address

1912 Memorial Ave
Lynchburg, VA 24501-1708

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
2202011915VAMDSpeech-Language Pathologist
2204001373VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1215777396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 MEMORIAL AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 MEMORIAL AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011708",
            "telephone_number": "434-845-8765",
            "fax_number": "434-845-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCURE",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204001373",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202011915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.