NPIMap

Organization Active NPI

Haislup

  • Speech-Language Pathologist
  • Saint Louis, MO
National Provider Identifier
1518162791
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LIFESTATE Issued in MO
Legal business name
HAISLUP
Practice address
100 S Garrison Ave
Saint Louis, MO 63103-2538
Phone
(314) 340-5902
NPI assigned
Jun 18, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Ruth A Fuller
Title
Speech Pathologist
Phone
(314) 892-8862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LIFESTATE MO Primary

Addresses

Primary practice location

100 S Garrison Ave
Saint Louis, MO 63103-2538

Mailing address

5511 Starlit Dr
Saint Louis, MO 63129-2245
Phone (314) 892-8862

Other identifiers 1

IdentifierTypeStateIssuer
466692811MedicaidMO

National Provider Directory

National Provider Directory

Locations

100 S Garrison Ave
Saint Louis, MO 63103
Phone (314) 340-5902

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1518162791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 STARLIT DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631292245",
            "telephone_number": "314-892-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S GARRISON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032538",
            "telephone_number": "314-340-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAISLUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "314-892-8862"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "LIFESTATE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466692811",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.