Staci L Moore, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

304 Eklund St
Pleasant Hill, MO 64080-1041

Phone

(816) 540-2119

Fax

(816) 540-5135

NPI assigned

Sep 16, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Staci L Frazier Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1982937363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E MYRTLE ST",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640801695",
            "telephone_number": "816-540-3161",
            "fax_number": "816-540-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 EKLUND ST",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640801041",
            "telephone_number": "816-540-2119",
            "fax_number": "816-540-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STACI",
        "middle_name": "L",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "FRAZIER",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Avery C Lough, MA, LPC
• Ashley Lyn Maxon
• Rebecca Lee McConville, MS RD CSSD LD
• Ashley Cheyenne McGuire, FNP
• Kara Beth Meeks, OTR
• Stephanie Ann Moskopp, LPC
• Dawn Christian Myers, LCMFT
• Dung Kim Nguyen, PHARM.D
• Northport Health Services of Missouri, LLC
• Panax Healthcare, Inc

• All providers in Pleasant Hill, MO
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.