Glenda Ann Raby, MS., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1118 Fairfield Rd
Mount Vernon, IL 62864-5726

Phone

(618) 244-8079

Fax

(618) 244-8078

NPI assigned

Sep 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Summersville SD 79

  • Local Education Agency (LEA)
  • Mount Vernon, IL
  • NPI 1871624338
  NPD (past)

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

{
    "created_epoch": "1506211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506211200000",
    "number": "1154830032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11385 STATE HIGHWAY 37",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628124415",
            "telephone_number": "618-927-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 FAIRFIELD RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628645726",
            "telephone_number": "618-244-8079",
            "fax_number": "618-244-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABY",
        "first_name": "GLENDA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-24",
        "last_updated": "2017-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16099017884",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prompt Care
• Melissa Pryer, RD
• Raquel Pulliam
• Osman Javed Qaiyum, M.D.
• Kent S Quinn, MD
• David Peter Rakey, CRNA
• Bryon Theron Ramos, ATC, CSCS
• Ronald Edward Rankin, DMD
• Tara Denise Rapp
• Taylor Rapp

• Speech-Language Pathologist in Mount Vernon, IL
• Providers in Mount Vernon, 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 Sep 24, 2017; 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.