Jodi Main

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2016022766 Issued in MO

Practice address

265 Steamboat LN
Ballwin, MO 63011-3203

Phone

(636) 227-2330

NPI assigned

Feb 21, 2017

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

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Howard Park Early Intervention Center

  • Voluntary or Charitable Agency
  • Fenton, MO
  • NPI 1396739124

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1821537051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 STEAMBOAT LN",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 STEAMBOAT LN",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113203",
            "telephone_number": "636-227-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIN",
        "first_name": "JODI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2016022766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lutheran Senior Services
• Lutheran Senior Services
• Caitlin Maas, M.ED., BCBA, LBA
• Kristi R Machica, LPC, RPT-S
• Brian L. Mahaffey, MD
• Mary Elizabeth Malen, N.P.
• Nisha Mali, OCCUPATIONAL THERAP
• Afshan Malik, LPC
• Nomana Malik
• Shannon Malon

• Speech-Language Pathologist in Ballwin, MO
• Providers in Ballwin, 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 Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.