Melissa Dawn Eversole

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

838467 Issued in IL

Practice address

200 Sherman St
Pana, IL 62557-1360

Phone

(217) 820-1064

NPI assigned

Jul 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Melissa Dawn Durbin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1043797293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 N 600 EAST RD",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625574000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SHERMAN ST",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625571360",
            "telephone_number": "217-820-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSOLE",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "838467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DURBIN",
            "middle_name": "DAWN",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Speech-Language Pathologist in Pana, IL
• Providers in Pana, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.