Active NPI
Miranda Kay Moss, MS/CCC-SLP
- Speech-Language Pathologist
- Monroe, LA
National Provider Identifier
1245542679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4892
- Practice address
- 4209 Ava LN
Monroe, LA 71201-2099 - Phone
- (318) 361-5057
- NPI assigned
- Jul 14, 2010
- Last updated
- Jul 14, 2010
- 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 | 4892 | LA | Primary |
Addresses
Primary practice location
4209 Ava LN
Monroe, LA 71201-2099
Mailing address
4209 Ava LN
Monroe, LA 71201-2099
Phone (318) 361-5057
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4892 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279065600000",
"number": "1245542679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4209 AVA LN",
"city": "MONROE",
"state": "LA",
"postal_code": "712012099",
"telephone_number": "318-361-5057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4209 AVA LN",
"city": "MONROE",
"state": "LA",
"postal_code": "712012099",
"telephone_number": "318-361-5057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "MIRANDA",
"middle_name": "KAY",
"credential": "MS/CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-14",
"last_updated": "2010-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "4892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.