Individual provider Active NPI

Rebecca Ann Davis, M.S., CCC-SLP/L

  • Speech-Language Pathologist
  • Saint Louis, MO
National Provider Identifier
1679603542
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2005021971 Issued in MO
Practice address
1352 Orchard View Dr
Saint Louis, MO 63146-5269
Phone
(314) 503-7250
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 2005021971 MO Primary

Addresses

Primary practice location

1352 Orchard View Dr
Saint Louis, MO 63146-5269

Mailing address

1352 Orchard View Dr
Saint Louis, MO 63146-5269
Phone (314) 503-7250

Other identifiers 1

IdentifierTypeStateIssuer
467597704MedicaidMO

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2005021971MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1679603542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 ORCHARD VIEW DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465269",
            "telephone_number": "314-503-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 ORCHARD VIEW DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465269",
            "telephone_number": "314-503-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2005021971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "467597704",
            "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 Nov 11, 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.

Verify at the official NPI Registry.