Susan Marie Abernathy, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

104631 Issued in MO

Practice address

1 Village Square Ctr
Suite a
Hazelwood, MO 63042-1817

Phone

(314) 731-4555

Fax

(314) 551-6110

NPI assigned

Aug 13, 2010

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)

Enrolled

Credentials

Master of Science

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.

• SSM Select Rehab St Louis LLC

  • Physical Medicine & Rehabilitation Physician
  • Richmond Heights, MO
  • NPI 1558403261
  NPD (past)

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1487969556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VILLAGE SQUARE CTR",
            "address_2": "SUITE A",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421817",
            "telephone_number": "314-731-4555",
            "fax_number": "314-551-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VILLAGE SQUARE CTR",
            "address_2": "SUITE A",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421817",
            "telephone_number": "314-731-4555",
            "fax_number": "314-551-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABERNATHY",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "104631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.