Individual provider Active NPI

Belinda B Pankoff

  • Speech-Language Pathologist
  • Wentzville, MO
National Provider Identifier
1811210172
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
02041 Issued in MO
Practice address
332 Stable LN
Wentzville, MO 63385-5447
Phone
(636) 332-4940
NPI assigned
Mar 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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 02041 MO Primary

Addresses

Primary practice location

332 Stable LN
Wentzville, MO 63385-5447

Mailing address

703 Sherwood Dr
Webster Groves, MO 63119-3755
Phone (314) 853-7772

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
02041MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Horsemanship Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1811210172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 SHERWOOD DR",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631193755",
            "telephone_number": "314-853-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 STABLE LN",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633855447",
            "telephone_number": "636-332-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKOFF",
        "first_name": "BELINDA",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "02041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; 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.