Roxy's House at Blue Heron Ranch

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

ROXY'S HOUSE AT BLUE HERON RANCH

Practice address

13801 N 130 East Rd
Homer, IL 61849-7018

Phone

(217) 431-5484

NPI assigned

Jul 19, 2023

Last updated

Jul 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roxy ReedNPI 1699939207

Title

Owner

Phone

(217) 369-4496

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roxy Lynn Reed, MA,CCC-SLP

  • Speech-Language Pathologist
  • Danville, IL
  • NPI 1699939207
  NPD Authorized official

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1124708771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 N 130 EAST RD",
            "city": "HOMER",
            "state": "IL",
            "postal_code": "618497018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 N 130 EAST RD",
            "city": "HOMER",
            "state": "IL",
            "postal_code": "618497018",
            "telephone_number": "217-431-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROXY'S HOUSE AT BLUE HERON RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "ROXY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-369-4496"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Santana Koebele, ED.S., NCSP
• Mahindra Patel, M.D. LTD
• Angela Marie McCarty, COTA
• Kathryn Mitrou, COTA/L
• Mahindra D. Patel, M.D.
• Pamela K. Tate, M.S.

• Speech-Language Pathologist in Homer, IL
• Providers in Homer, 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 19, 2023; 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.