Active NPI
Molly Stoddard
- Speech-Language Pathologist
- San Luis Obispo, CA
National Provider Identifier
1336717842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 1130 Grove St
San Luis Obispo, CA 93401-2914 - Phone
- (805) 543-3945
- NPI assigned
- Jun 12, 2021
- 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 | Primary |
Addresses
Primary practice location
1130 Grove St
San Luis Obispo, CA 93401-2914
Mailing address
536 Ash St
Los Osos, CA 93402-2504
Phone (805) 291-7888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210810003629 | CA | Practitioner - Qualified Speech Language Pathologist | 8123422326 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1130 Grove St
San Luis Obispo, CA 93401-2914
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31987 | CA | MD | General Practice Dentistry |
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": "1623456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623456000000",
"number": "1336717842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "536 ASH ST",
"city": "LOS OSOS",
"state": "CA",
"postal_code": "934022504",
"telephone_number": "805-291-7888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 GROVE ST",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012914",
"telephone_number": "805-543-3945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STODDARD",
"first_name": "MOLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-12",
"last_updated": "2021-06-12",
"certification_date": "2021-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2021; 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.