Mia Kelly Patterson, MS, CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

12563 Village Circle Dr
Saint Louis, MO 63127-1758

Phone

(314) 593-0834

NPI assigned

May 28, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mia Kelly Patterson Professional name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smart Rehab, LLCGroup PAC ID 1759668643, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Smart Rehab, LLC

  • Physical Therapist
  • Kirkwood, MO
  • NPI 1144760471
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1699515767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRAQUEWOOD CT",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630216403",
            "telephone_number": "314-593-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12563 VILLAGE CIRCLE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271758",
            "telephone_number": "314-593-0834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15201 Olive Blvd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630171810",
            "country_code": "US",
            "telephone_number": "636-898-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "MIA",
        "middle_name": "KELLY",
        "credential": "MS, CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "PATTERSON",
            "middle_name": "KELLY",
            "credential": "MS, CF-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jenny Elizabeth Patterson
• Kacey Alexandra Patterson, PMHNP-BC
• Lacy Ann Patterson, PHARM.D.
• Marissa Patterson
• Melody Ann Patterson, APRN, BC
• Phillip Patterson
• Robert H Patterson, DO
• Taylor J Patterson, MD
• Tessa Brooke Patterson, WHNP
• Patton Chiropractic, Inc.

• Speech-Language Pathologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.