Individual provider Active NPI

Susan Irons, MST

  • Speech-Language Pathologist
  • Urbana, IL
National Provider Identifier
1194976415
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
810 W Anthony Dr
Urbana, IL 61802-7431
Phone
(217) 326-2911
Fax
(217) 344-8047
NPI assigned
Oct 6, 2008
Last updated
Dec 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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 NU Primary

Addresses

Primary practice location

810 W Anthony Dr
Urbana, IL 61802-7431

Mailing address

611 W Park St
Urbana, IL 61801-2500
Phone (217) 326-2911

Other identifiers 5

IdentifierTypeStateIssuer
4117OtherILHAMP PROVIDER ID
7216OtherPERSONALCARE PROV ID
343785560001MedicaidIL
113326OtherHEALTHLINK PROVIDER ID
203OtherILBLUE CROSS PROV ID

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

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1194976415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-326-2911",
            "fax_number": "217-344-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W ANTHONY DR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618027431",
            "telephone_number": "217-326-2911",
            "fax_number": "217-344-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRONS",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAMP PROVIDER ID",
            "identifier": "4117",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONALCARE PROV ID",
            "identifier": "7216",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343785560001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER ID",
            "identifier": "113326",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROV ID",
            "identifier": "203",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.