Megan Marie Moore, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17270 Issued in ID

Practice address

1893 Jennie Lee Dr Apt 101
Idaho Falls, ID 83404-6161

Phone

(715) 566-0806

NPI assigned

Dec 30, 2024

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

State licenses

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1396553830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 JENNIE LEE DR APT 101",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046161",
            "telephone_number": "715-566-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 JENNIE LEE DR APT 101",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046161",
            "telephone_number": "715-566-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "17270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Mooney, BEHAVIOR SPECIALIST
• Amanda Moore, LPC
• Heather A Moore, RN
• Jared Lee Moore, PHARMD
• Kailey Lynn Moore
• Michael Kirk Moore Jr., M.D., P.C.
• Moose Creek Anesthesia PC
• Mooso Orthodontics
• Brett Eddis Mooso, D.D.S.,M.S.,P.A.
• Karla Jerica Mora-Cardona, BS

• Speech-Language Pathologist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.