Individual provider Active NPI

Rachel Lauren Massa, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Marion, IL
National Provider Identifier
1023420015
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.012188 Issued in IL
Practice address
411 S Court St
Marion, IL 62959-2711
Phone
(618) 993-2138
NPI assigned
May 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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 146.012188 IL Primary

Addresses

Primary practice location

411 S Court St
Marion, IL 62959-2711

Mailing address

1722 Norman Rd
Marion, IL 62959-5965
Phone (618) 978-0349

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146.012188ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Williamson County Special Ed PastSince Sep 23, 2024 Accepting new patients
Williamson Co. Special Education District PastSince Sep 23, 2024 Accepting new patients

Organizations & group practices 2

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": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1023420015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 NORMAN RD",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595965",
            "telephone_number": "618-978-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S COURT ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629592711",
            "telephone_number": "618-993-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSA",
        "first_name": "RACHEL",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.012188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.