Individual provider Active NPI

Stephanie Lynn Neiswender, ST

  • Speech-Language Pathologist
  • Quincy, IL
National Provider Identifier
1013192863
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146-007671 Issued in IL
Practice address
2137 Jersey St
Quincy, IL 62301-4339
Phone
(217) 430-4435
NPI assigned
Dec 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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 146-007671 IL Primary

Addresses

Primary practice location

2137 Jersey St
Quincy, IL 62301-4339

Mailing address

2137 Jersey St
Quincy, IL 62301-4339
Phone (217) 430-4435

Other practice location 1

5 State and 8th Plz
Quincy, IL 62301-4960
Phone (217) 224-1750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220917000505 IL Practitioner - Qualified Speech Language Pathologist 7315322989 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Illinois LLCGroup PAC ID 2365718277, 361 clinicians

Practice addresses (Care Compare)

7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146-007671ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Speech-Language Pathologist CurrentSince Sep 3, 2024 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Sep 3, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Sep 3, 2024 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Sep 3, 2024 Accepting new patients
Communicate Speech Therapy Services, PLLC Speech-Language Pathologist CurrentSince Aug 22, 2022 Accepting new patients
First Choice Physical Therapy of Hannibal, LLC Speech-Language Pathologist PastSince Jul 24, 2022 Accepting new patients
First Choice Physical Therapy Speech-Language Pathologist Past Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1013192863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 JERSEY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014339",
            "telephone_number": "217-430-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 JERSEY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014339",
            "telephone_number": "217-430-4435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 State and 8th Plz",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623014960",
            "country_code": "US",
            "telephone_number": "217-224-1750",
            "fax_number": "217-224-0403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEISWENDER",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "ST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146-007671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.