Ellen L. Weinbaum, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

111656 Issued in MO

Practice address

17599 Highway 8
Saint James, MO 65559-8227

Phone

(573) 265-0436

NPI assigned

Sep 12, 2008

Last updated

Sep 12, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1699924852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655590506",
            "telephone_number": "573-265-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17599 HIGHWAY 8",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655598227",
            "telephone_number": "573-265-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBAUM",
        "first_name": "ELLEN",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "111656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Saint James, MO
• Providers in Saint James, 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 Sep 12, 2008; 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.