Anna M Walley, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2024019909 Issued in MO

Practice address

210 S 2ND St Ste a
Clinton, MO 64735-2172

Phone

(660) 885-2394

Fax

(660) 383-1650

NPI assigned

Apr 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pediatric Place, LLC

  • Speech-Language Pathologist
  • Clinton, MO
  • NPI 1437819364
  NPD (past)

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1477300366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S 2ND ST STE A",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352172",
            "telephone_number": "660-885-2394",
            "fax_number": "660-383-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 2ND ST STE A",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352172",
            "telephone_number": "660-885-2394",
            "fax_number": "660-383-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEY",
        "first_name": "ANNA",
        "middle_name": "M",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-06-17",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2022003370",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2024019909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark D Vogt, D.O.
• Dawnee Wade
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Sylvan E Ward, LPC
• Anna-Marie Watson, LPN
• Daniel John Weber, O.D.
• Jillian Wells, LMSW
• Kelly May Wenberg, CSFA

• All providers in Clinton, MO
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.