Active NPI
Moriah M Mattevi, M.A., CCC-SLP
- Speech-Language Pathologist
- Duluth, MN
National Provider Identifier
1871832535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8847
- Practice address
- 2501 Rice Lake Rd
Duluth, MN 55811-4819 - Phone
- (218) 625-6400
- NPI assigned
- Jan 31, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8847 | MN | Primary |
| Speech-Language Pathologist | 235Z00000X | 3692-154 | WI |
Addresses
Primary practice location
2501 Rice Lake Rd
Duluth, MN 55811-4819
Mailing address
4318 Cooke St
Duluth, MN 55804-1948
Phone (218) 348-1576
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3692-154 | WI | MD | Speech-Language Pathologist |
| 8847 | MN | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1871832535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4318 COOKE ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558041948",
"telephone_number": "218-348-1576",
"fax_number": "218-625-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 RICE LAKE RD",
"city": "DULUTH",
"state": "MN",
"postal_code": "558114819",
"telephone_number": "218-625-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTEVI",
"first_name": "MORIAH",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-31",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "8847",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "3692-154",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.