Miranda R Moe, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2965-154 Issued in WI

Practice address

185 S Chet Krause Dr
Iola, WI 54945-9300

Phone

(715) 445-2412

NPI assigned

May 23, 2012

Last updated

May 25, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1265792279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10464 COUNTY ROAD B",
            "city": "AMHERST",
            "state": "WI",
            "postal_code": "544068940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S CHET KRAUSE DR",
            "city": "IOLA",
            "state": "WI",
            "postal_code": "549459300",
            "telephone_number": "715-445-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "MIRANDA",
        "middle_name": "R",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2965-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Stumpp, DNP, PLLC
• Lauren Kelley, CCC-SLP
• James S. Maus, DDS
• Deanna Marie McKinney, RDH
• Mjcare
• National Birth Centers, Inc.
• Osl Iola Operating LLC
• Jane Crawford Peterson, LM
• Private Healthcare Facilities
• Refocus Eyecare Center, LLC

• Speech-Language Pathologist in Iola, WI
• Providers in Iola, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.