Jennifer L Mollerus

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2017026187 Issued in MO

Practice address

3321 Georgia St
Louisiana, MO 63353-2751

Phone

(573) 754-6181

NPI assigned

Nov 21, 2017

Last updated

Nov 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hannibal School District #60

  • Local Education Agency (LEA)
  • Hannibal, MO
  • NPI 1821143082
  NPD (past)

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1750895108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 GEORGIA ST",
            "city": "LOUISIANA",
            "state": "MO",
            "postal_code": "633532751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3321 GEORGIA ST",
            "city": "LOUISIANA",
            "state": "MO",
            "postal_code": "633532751",
            "telephone_number": "573-754-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLERUS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2017026187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750895108",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Laura J Mitchell, MD
• Ronald C Myers, D.O.
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• Northeast Missouri Medical Providers LLC
• Jan F Onik, DO
• Viola Irene Perrigo Hennekes, SLPD,CCC-SLP

• Speech-Language Pathologist in Louisiana, MO
• Providers in Louisiana, 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 Nov 22, 2021; 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.