Jacey Renee Dillon
Individual provider Active NPI Speech-Language Pathologist · Charleston, IL
NPI 1043837883 · NPPES record last updated Mar 31, 2021
Key facts
- NPI
- 1043837883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 2119 Stoner Dr W
Charleston, IL 61920-3723 - Phone
- (217) 549-6518
- NPI assigned
- Jun 27, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arise Therapies LLC
Practice addresses (Care Compare)
3011 Longford Dr
Suite 4
Spring Hill, TN 37174-6203
Phone (615) 241-0122
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221014000375 | TN | Practitioner - Qualified Speech Language Pathologist | 2961878061 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arise Therapies LLC | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
3011 Longford Dr
Ste 4
Spring Hill, TN 37174
Phone (615) 241-0122
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
2119 Stoner Dr W
Charleston, IL 61920-3723
Mailing address
2119 Stoner Dr W
Charleston, IL 61920-3723
Phone (217) 549-6518
Other providers in Charleston, IL
- Dental Professionals of Illinois, P.C.
- Michaela Elizabeth Desantis
- Developmental Foundations, Inc.
- Developmental Foundations, Inc.
- Developmental Foundations, Inc.
- Donna Turner Hudson
- Courtney Ella Dundee
- Sandra J Durham
- Darcy L Duzan
- Dva Renal Healthcare Inc
All providers in Charleston, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.