Individual provider Active NPI

Moriah Bledsoe, CCC-SLP

  • Speech-Language Pathologist
  • Johnson City, TN
National Provider Identifier
1619765252
Registry record updated Apr 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8955 Issued in TN
Practice address
2214 E Fairview Ave
Johnson City, TN 37601-2860
Phone
(423) 928-6464
NPI assigned
Apr 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8955 TN Primary

Addresses

Primary practice location

2214 E Fairview Ave
Johnson City, TN 37601-2860

Mailing address

104 Keeland Dr
Gray, TN 37615-4218

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Therapy Speech-Language Pathologist CurrentSince Apr 27, 2025 Accepting new patients
Mini Miracles Pediatric Therapy, PLLC CurrentSince Apr 27, 2025 Accepting new patients

Locations

2214 E Fairview Ave
Johnson City, TN 37601
Phone (423) 928-6464

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775952000000",
    "number": "1619765252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 KEELAND DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376154218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 E FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012860",
            "telephone_number": "423-928-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "MORIAH",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-25",
        "last_updated": "2026-04-12",
        "certification_date": "2026-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "8955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2026; 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.