Active NPI
Judith Peavey
- Speech-Language Pathologist
- Springfield, MO
National Provider Identifier
1992109482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 105835
- Practice address
- 716 S Fremont Ave
Springfield, MO 65804-0112 - Phone
- (417) 860-1636
- NPI assigned
- Oct 13, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 105835 | MO | Primary |
Addresses
Primary practice location
716 S Fremont Ave
Springfield, MO 65804-0112
Mailing address
716 S Fremont Ave
Springfield, MO 65804-0112
Phone (417) 860-1636
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105835 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413158400000",
"number": "1992109482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 S FREMONT AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658040112",
"telephone_number": "417-860-1636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 S FREMONT AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658040112",
"telephone_number": "417-860-1636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEAVEY",
"first_name": "JUDITH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-13",
"last_updated": "2014-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "105835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.