Individual provider Active NPI

Janis Nelson

  • Speech-Language Pathologist
  • Missoula, MT
National Provider Identifier
1255069035
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-SP-LIC-10687 Issued in MT
Practice address
3031 S Russell St Ste B
Missoula, MT 59801-8523
Phone
(406) 396-4130
Fax
(406) 797-5008
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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 SLP-SP-LIC-10687 MT Primary

Addresses

Primary practice location

3031 S Russell St Ste B
Missoula, MT 59801-8523

Mailing address

3031 S Russell St Ste B
Missoula, MT 59801-8523
Phone (406) 396-4130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220928001570 MT Practitioner - Qualified Speech Language Pathologist 9739565714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moving Mountains Therapy Center, PLLCGroup PAC ID 6709298276, 7 clinicians

Practice addresses (Care Compare)

3031 S Russell St
Suite B
Missoula, MT 59801-8523
Phone (406) 396-4130

700 SW Higgins Ave
Suite 103
Missoula, MT 59803-1489
Phone (952) 356-6778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moving Mountains Therapy Center, PLLC Speech-Language Pathologist CurrentSince Jan 2, 2024 Accepting new patients

Locations

3031 S Russell St
Ste B
Missoula, MT 59801
Phone (406) 396-4130

700 SW Higgins Ave
Ste 103
Missoula, MT 59803
Phone (406) 396-4130

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1255069035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 S RUSSELL ST STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018523",
            "telephone_number": "406-396-4130",
            "fax_number": "406-797-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 S RUSSELL ST STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018523",
            "telephone_number": "406-396-4130",
            "fax_number": "406-797-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JANIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "SLP-SP-LIC-10687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.