Individual provider Active NPI

Meghan Layne Moline

  • Speech-Language Pathologist
  • North Adams, MA
National Provider Identifier
1356100507
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP101173 Issued in MA
Practice address
175 Franklin St
North Adams, MA 01247-2712
Phone
(413) 664-4041
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X SLP101173 MA Primary

Addresses

Primary practice location

175 Franklin St
North Adams, MA 01247-2712

Mailing address

1021 Red Maple St
Centerton, AR 72719-6059
Phone (573) 778-8564

Other practice location 1

5321 Beverly Park Cir
Knoxville, TN 37918-9253
Phone (865) 687-1321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241211004263 AR Practitioner - Qualified Speech Language Pathologist 3072049196 Reassigns benefits to 1 organization
I20250116001809 CO Practitioner - Qualified Speech Language Pathologist 3072049196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

10001 S Oswego St
Parker, CO 80134-3786
Phone (720) 386-5023

14501 E Crestline Dr
Centennial, CO 80015-2559
Phone (303) 918-1219

3800 SW Mount Carmel Dr
Bentonville, AR 72713-1012
Phone (479) 268-3207

6021 S Liverpool St
Aurora, CO 80016-6209
Phone (720) 504-7016

6383 E Girard PL
Denver, CO 80222-7447
Phone (720) 221-4266

7390 W Eastman Place
Lakewood, CO 80227-5039
Phone (720) 504-7030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP101173MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Nov 25, 2024 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Nov 25, 2024 Accepting new patients
Legacy Healthcare Services Inc. Speech-Language Pathologist CurrentSince Jan 10, 2025 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 3

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": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1356100507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 RED MAPLE ST",
            "city": "CENTERTON",
            "state": "AR",
            "postal_code": "727196059",
            "telephone_number": "573-778-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FRANKLIN ST",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472712",
            "telephone_number": "413-664-4041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5321 Beverly Park Cir",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379189253",
            "country_code": "US",
            "telephone_number": "865-687-1321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLINE",
        "first_name": "MEGHAN",
        "middle_name": "LAYNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "SLP101173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Adams, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.