Individual provider Active NPI

Alyssa Ann Orton, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Peoria, IL
National Provider Identifier
1184064743
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22005711A Issued in IN
Practice address
Peoria Developmental Center
2018 W Cimarron Drive
Peoria, IL 61614-6161
Phone
(309) 693-4424
NPI assigned
Jun 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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 22005711A IN Primary

Addresses

Primary practice location

Peoria Developmental Center
2018 W Cimarron Drive
Peoria, IL 61614-6161

Mailing address

357 E Eller Dr
East Peoria, IL 61611-5418
Phone (309) 269-6120

Other practice location 1

1701 Library Blvd
Suite A
Greenwood, IN 46142-1567
Phone (317) 881-9923

Other identifiers 1

IdentifierTypeStateIssuer
146011140OtherILILLINOIS SPEECH LANGUAGE PATHOLOGIST LICENSE

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22005711AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborating for Kids, LLC PastSince Feb 19, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1184064743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 E ELLER DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616115418",
            "telephone_number": "309-269-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEORIA DEVELOPMENTAL CENTER",
            "address_2": "2018 W CIMARRON DRIVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616146161",
            "telephone_number": "309-693-4424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Library Blvd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461421567",
            "country_code": "US",
            "telephone_number": "317-881-9923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTON",
        "first_name": "ALYSSA",
        "middle_name": "ANN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005711A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS SPEECH LANGUAGE PATHOLOGIST LICENSE",
            "identifier": "146011140",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.