Individual provider Active NPI

Christina S Hardin-Weiss

  • Speech-Language Pathologist
  • O Fallon, IL
National Provider Identifier
1104396084
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146066548 Issued in IL
Practice address
252 Peoria LN
O Fallon, IL 62269-3583
Phone
(618) 206-8401
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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 146066548 IL Primary

Addresses

Primary practice location

252 Peoria LN
O Fallon, IL 62269-3583

Mailing address

252 Peoria LN
O Fallon, IL 62269-3583
Phone (618) 206-8401

Other practice location 1

225 Castellano Dr
Swansea, IL 62226-3027
Phone (618) 416-6161

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
146066548ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1104396084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 PEORIA LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693583",
            "telephone_number": "618-206-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 PEORIA LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693583",
            "telephone_number": "618-206-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Castellano Dr",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622263027",
            "country_code": "US",
            "telephone_number": "618-416-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDIN-WEISS",
        "first_name": "CHRISTINA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146066548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.