Individual provider Active NPI

Denise Julianne Croft, MS

  • Speech-Language Pathologist
  • Carbondale, IL
National Provider Identifier
1194337329
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146015234 Issued in IL
Practice address
925 S Giant City Rd
Carbondale, IL 62902-5056
Phone
(618) 457-3591
NPI assigned
Aug 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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 146015234 IL Primary

Addresses

Primary practice location

925 S Giant City Rd
Carbondale, IL 62902-5056

Mailing address

703 Rachael CT
Carterville, IL 62918-1051
Phone (224) 595-0654

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
146015234ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carbondale Elem School PastSince Aug 23, 2020 Accepting new patients
Carbondale Elem SCH Dist 95 PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1194337329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RACHAEL CT",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181051",
            "telephone_number": "224-595-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S GIANT CITY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629025056",
            "telephone_number": "618-457-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFT",
        "first_name": "DENISE",
        "middle_name": "JULIANNE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146015234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.