Individual provider Active NPI

Michelle Lynn Dampf

  • Speech-Language Pathologist
  • Columbia, MO
National Provider Identifier
1962693846
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
118487 Issued in MO
Practice address
205 Portland St
Columbia, MO 65201-6521
Phone
(573) 884-5596
Fax
(573) 884-1151
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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 118487 MO Primary

Addresses

Primary practice location

205 Portland St
Columbia, MO 65201-6521

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 882-3300

Other practice location 1

1444 Sunset Lake Rd
Jefferson City, MO 65109-2441
Phone (573) 690-0760

Other identifiers 1

IdentifierTypeStateIssuer
465236313MedicaidMO

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
118487MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1962693846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-882-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PORTLAND ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016521",
            "telephone_number": "573-884-5596",
            "fax_number": "573-884-1151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1444 Sunset Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651092441",
            "country_code": "US",
            "telephone_number": "573-690-0760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMPF",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "118487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465236313",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.