MEDICARE: PARAGON SPEECH PATHOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1205873023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAGON SPEECH PATHOLOGY INC

Provider Business Mailing Address
First Line	:	1214 WOODS CHAPEL RD
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-2620
Country	:	US
Telephone Number	:	816-228-4310
Fax Number	:	816-228-4365

Provider Business Practice Location Address
First Line	:	3421 NW JEFFERSON ST STE A
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-8013
Country	:	US
Telephone Number	:	816-228-4310
Fax Number	:	816-228-4365

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. JAMIE S RUSSELL
Credential	:	M.S., CCC. SLP
Telephone Number	:	816-228-4310

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	09/11/2025

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Directions to “PARAGON SPEECH PATHOLOGY INC ” Practice Location

Language	Start Address	Practice Location

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