Active NPI
Elizabeth L Riedemann
- Speech-Language Pathologist
- O Fallon, MO
National Provider Identifier
1891989984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 109145
- Practice address
- 110 Virgil St
Fort Zumwalt School District
O Fallon, MO 63366-2637 - Phone
- (636) 240-2072
- Fax
- (636) 980-1946
- NPI assigned
- Aug 31, 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 | 109145 | MO | Primary |
Addresses
Primary practice location
110 Virgil St
Fort Zumwalt School District
O Fallon, MO 63366-2637
Mailing address
110 Virgil St
O Fallon, MO 63366-2637
Phone (636) 240-2072
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 |
|---|---|---|---|
| 109145 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Clinical Care | 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": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235001600000",
"number": "1891989984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 VIRGIL ST",
"city": "O FALLON",
"state": "MO",
"postal_code": "633662637",
"telephone_number": "636-240-2072",
"fax_number": "636-980-1946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 VIRGIL ST",
"address_2": "FORT ZUMWALT SCHOOL DISTRICT",
"city": "O FALLON",
"state": "MO",
"postal_code": "633662637",
"telephone_number": "636-240-2072",
"fax_number": "636-980-1946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIEDEMANN",
"first_name": "ELIZABETH",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-31",
"last_updated": "2009-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "109145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.