Individual provider Active NPI

Rebecca Moore

  • Speech-Language Pathologist
  • Oklahoma City, OK
National Provider Identifier
1285890954
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3811 Issued in OK
Practice address
7201 N Classen Blvd
Suite 106
Oklahoma City, OK 73116-7100
Phone
(405) 830-1335
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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 3811 OK Primary

Addresses

Primary practice location

7201 N Classen Blvd
Suite 106
Oklahoma City, OK 73116-7100

Mailing address

7201 N Classen Blvd
Suite 106
Oklahoma City, OK 73116-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703001495 OH Practitioner - Qualified Speech Language Pathologist 9830314947 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3811OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Canton Speech CurrentSince Sep 17, 2023 Accepting new patients

Locations

3720 Dressler Rd NW
Canton, OH 44718
Phone (330) 309-3133

Organizations & group practices 2

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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1285890954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 N CLASSEN BLVD",
            "address_2": "SUITE 106",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731167100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 N CLASSEN BLVD",
            "address_2": "SUITE 106",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731167100",
            "telephone_number": "405-830-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.