Sandra Renee Moog, MS/CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2681-154 Issued in WI

Practice address

3540 S 43Rd St
Milwaukee, WI 53220-1502

Phone

(414) 328-2104

NPI assigned

Apr 12, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reliant Senior Living LLCGroup PAC ID 0446754451, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Reliant Senior Living LLC

  • Physical Therapist
  • Shorewood, WI
  • NPI 1013899582
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1207958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207958400000",
    "number": "1467625269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 S 35TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154104",
            "telephone_number": "414-333-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 S 43RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532201502",
            "telephone_number": "414-328-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOG",
        "first_name": "SANDRA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MS/CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-12",
        "last_updated": "2008-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2681-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42586400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Moody
• Hannah Moody, ATC, LAT
• Raven Moody, MSW
• Emily Ann Mooers, MD
• Harrison Mooers
• Emily Moon, APNP
• Jacklyn J Moon, DDS
• Maryann McKenna Moon, R.N. C.N.S.
• Ousia Moon, APSW
• Christopher David Mooney

• Speech-Language Pathologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2008; 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.