Individual provider Active NPI

Krysten McGough

  • Speech-Language Assistant
  • Saint Peters, MO
National Provider Identifier
1710286182
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA12918 Issued in AZ
Practice address
460 McMenamy Rd
Saint Peters, MO 63376-1510
Phone
(636) 397-3111
NPI assigned
Mar 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A01821 MD
Speech-Language Pathologist 235Z00000X 2025031413 MO
Speech-Language Assistant 2355S0801X SLPA12918 AZ Primary

Addresses

Primary practice location

460 McMenamy Rd
Saint Peters, MO 63376-1510

Mailing address

1306 Avondale Spring Dr
O Fallon, MO 63368-7993
Phone (064) 531-5402

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

State licenses

LicenseStateTypeSpecialty
A01821MDMDOccupational Therapy Assistant
SLPA12918AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1710286182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 AVONDALE SPRING DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687993",
            "telephone_number": "064-531-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MCMENAMY RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761510",
            "telephone_number": "636-397-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOUGH",
        "first_name": "KRYSTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A01821",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2025031413",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA12918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.