Individual provider Active NPI

Michelle Gummig, SLP

  • Speech-Language Pathologist
  • Liberty, MO
National Provider Identifier
1730666322
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2017005020 Issued in MO
Practice address
398 Blue Jay Dr
Liberty, MO 64068-1977
Phone
(816) 407-2315
Fax
(816) 407-1555
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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 2017005020 MO Primary

Addresses

Primary practice location

398 Blue Jay Dr
Liberty, MO 64068-1977

Mailing address

2525 Glenn Hendren Dr
Liberty, MO 64068-9600
Phone (816) 792-2000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017005020MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1730666322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 GLENN HENDREN DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689600",
            "telephone_number": "816-792-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 BLUE JAY DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681977",
            "telephone_number": "816-407-2315",
            "fax_number": "816-407-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMMIG",
        "first_name": "MICHELLE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2017005020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.