Active NPI
Jessica Dawn Spoonster
- Speech-Language Pathologist
- Elsberry, MO
National Provider Identifier
1861527426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2005004544
- Practice address
- 138 Tomahawk
Elsberry R-II
Elsberry, MO 63343-0106 - Phone
- (573) 898-5554
- Fax
- (573) 898-3140
- NPI assigned
- Feb 23, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2005004544 | MO | Primary |
Addresses
Primary practice location
138 Tomahawk
Elsberry R-II
Elsberry, MO 63343-0106
Mailing address
PO Box 106
138 Tomahawk
Elsberry, MO 63343-0106
Phone (573) 898-5554
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2005004544 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln County R2 School District | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba School District R-II Elsberry
- Local Education Agency (LEA)
- Elsberry, MO
- NPI 1265572556
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861527426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 106",
"address_2": "138 TOMAHAWK",
"city": "ELSBERRY",
"state": "MO",
"postal_code": "633430106",
"telephone_number": "573-898-5554",
"fax_number": "573-898-3140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 TOMAHAWK",
"address_2": "ELSBERRY R-II",
"city": "ELSBERRY",
"state": "MO",
"postal_code": "633430106",
"telephone_number": "573-898-5554",
"fax_number": "573-898-3140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOONSTER",
"first_name": "JESSICA",
"middle_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2005004544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elsberry, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.