Active NPI
Sara Mousavi
- Speech-Language Pathologist
- Columbia, SC
National Provider Identifier
1477160919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7326
- Practice address
- 720 Gracern Rd Ste 450
Columbia, SC 29210-7657 - Phone
- (803) 667-7835
- Fax
- (803) 897-8179
- NPI assigned
- Sep 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 7326 | SC | Primary |
Addresses
Primary practice location
720 Gracern Rd Ste 450
Columbia, SC 29210-7657
Mailing address
720 Gracern Rd Ste 450
Columbia, SC 29210-7657
Phone (803) 667-7835
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP5549 | Medicaid | SC |
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 |
|---|---|---|---|
| 7326 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601337600000",
"number": "1477160919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 GRACERN RD STE 450",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292107657",
"telephone_number": "803-667-7835",
"fax_number": "803-897-8179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 GRACERN RD STE 450",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292107657",
"telephone_number": "803-667-7835",
"fax_number": "803-897-8179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSAVI",
"first_name": "SARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-29",
"last_updated": "2020-09-29",
"certification_date": "2020-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "7326",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP5549",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.