Active NPI
Molly Gray
- Speech-Language Pathologist
- Zachary, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 9677
- Practice address
- 4845 Church Street
Suite B
Zachary, LA 70791 - Phone
- (225) 654-8208
- NPI assigned
- Jul 10, 2024
- Last updated
- Jul 10, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 9677 | NU | Primary |
Addresses
Primary practice location
4845 Church Street
Suite B
Zachary, LA 70791
Mailing address
4324 S Sherwood Forest Blvd Ste B170
Baton Rouge, LA 70816-4481
Phone (225) 654-8208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9677 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moreau Physical Therapy Inc. | Speech-Language Pathologist | Current | Accepting new patients |
| Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82 | Current | Accepting new patients |
Locations
11424 Sullivan Rd
#A-C
Baton Rouge, LA 70818
Phone (225) 261-7021
4324 S Sherwood Frst
Ste B170
Baton Rouge, LA 70816
4845 Main St
#B
Zachary, LA 70791
Phone (225) 238-2955
4845 Main St
#C
Zachary, LA 70791
Phone (225) 286-0181
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Moreau Physical Therapy
- Physical Therapist
- Baton Rouge, LA
- NPI 1770568669
Speech-Language Pathologist
-
dba Moreau Physical Therapy
- Physical Therapist
- Beaumont, TX
- NPI 1831962018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1568209369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4324 S SHERWOOD FOREST BLVD STE B170",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708164481",
"telephone_number": "225-654-8208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4845 CHURCH STREET",
"address_2": "SUITE B",
"city": "ZACHARY",
"state": "LA",
"postal_code": "70791",
"telephone_number": "225-654-8208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "MOLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-10",
"last_updated": "2024-07-10",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NU",
"license": "9677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Zachary, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.