Active NPI
Over the Moon Speech Therapy
- Speech-Language Pathologist
- Roanoke, VA
National Provider Identifier
1669208633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- OVER THE MOON SPEECH THERAPY
- Practice address
- 4402 Fontaine Dr
Roanoke, VA 24018-2913 - Phone
- (859) 317-1838
- NPI assigned
- Sep 9, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hillary Erp
- Title
- Owner
- Phone
- (859) 317-1838
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
4402 Fontaine Dr
Roanoke, VA 24018-2913
Mailing address
4402 Fontaine Dr
Roanoke, VA 24018-2913
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Speech-Language Pathologist
- Roanoke, VA
- NPI 1023797859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1725840000000",
"number": "1669208633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4402 FONTAINE DR",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240182913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4402 FONTAINE DR",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240182913",
"telephone_number": "859-317-1838"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OVER THE MOON SPEECH THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A",
"authorized_official_last_name": "ERP",
"authorized_official_first_name": "HILLARY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "859-317-1838"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.