Active NPI
Laura Peterson
- Speech-Language Pathologist
- Saint Louis, MO
National Provider Identifier
1376926634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2015018772
- Practice address
- 330 N Gore Ave
Saint Louis, MO 63119-1600 - Phone
- (314) 968-2060
- NPI assigned
- Jul 6, 2015
- 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 | 2015018772 | MO | Primary |
Addresses
Primary practice location
330 N Gore Ave
Saint Louis, MO 63119-1600
Mailing address
9118 Heritage Dr
Apt B
Saint Louis, MO 63123-4149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015018772 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Clinical Care | Speech-Language Pathologist | Past | Accepting new patients |
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": "1436140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436140800000",
"number": "1376926634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9118 HERITAGE DR",
"address_2": "APT B",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631234149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N GORE AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631191600",
"telephone_number": "314-968-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-06",
"last_updated": "2015-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2015018772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.