Spoon River Hearing Services Inc

Primary specialty

AudiologistTaxonomy code 231H00000X

License

147000582 Issued in IL

Legal business name

SPOON RIVER HEARING SERVICES INC

Practice address

180 S Main St
Canton, IL 61520-2608

Phone

(309) 647-0201

Fax

(309) 649-8950

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sandi Greene Deford, M.S. CCC-ANPI 1689704660

Title

Audiologist

Phone

(309) 647-0201

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandi Greene Deford, M.S.

  • Audiologist
  • Canton, IL
  • NPI 1689704660
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1003030115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 W AVENUE H",
            "city": "LEWISTOWN",
            "state": "IL",
            "postal_code": "615428363",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOON RIVER HEARING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "DEFORD",
        "authorized_official_first_name": "SANDI",
        "authorized_official_middle_name": "GREENE",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "309-647-0201",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147000582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35672291302",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKenzie Skaggs
• Carissa Elizabeth Slobodecki, DPT
• Jimmie Marquette Smith, MD
• Spoon River Counseling & Wellness PLLC
• Spoon River Family Practice Center, Inc
• Stan Buczko RPH
• Andrea Steliga-Phillips, PSYD
• Amanda L Stephenson, DPT
• Fordyce Edward Stivers, MD
• Cassie J Stone, CFNP

• Audiologist in Canton, IL
• Providers in Canton, IL by specialty
• Audiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.