Active NPI
Amaretta Marie Gilmer, M.S. CCC-SLP
- Speech-Language Pathologist
- Springfield, IL
National Provider Identifier
1205050192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242000431
- Practice address
- 4046 McConnell CT
Springfield, IL 62707-3018 - Phone
- (217) 753-1213
- NPI assigned
- Apr 12, 2007
- Last updated
- Apr 11, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242000431 | IL | Primary |
| Speech-Language Pathologist | 235Z00000X | SA 10348 | FL | |
| Speech-Language Pathologist | 235Z00000X | 16668 | CA | |
| Speech-Language Pathologist | 235Z00000X | LL 60024121 | WA | |
| Speech-Language Pathologist | 235Z00000X | 104524 | TX | |
| Speech-Language Pathologist | 235Z00000X | 22004804A | IN | |
| Speech-Language Pathologist | 235Z00000X | 7814 | MA |
Addresses
Primary practice location
4046 McConnell CT
Springfield, IL 62707-3018
Mailing address
4046 McConnell CT
Springfield, IL 62707-3018
Phone (217) 753-1213
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16668 | CA | MD | Professional Counselor |
| 7814 | MA | MD | Clinical Social Worker |
| SA 10348 | FL | MD | Speech-Language Pathologist |
| 242000431 | IL | MD | Speech-Language Pathologist |
| 22004804A | IN | MD | Speech-Language Pathologist |
| 104524 | TX | MD | Speech-Language Pathologist |
| LL 60024121 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270944000000",
"number": "1205050192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4046 MCCONNELL CT",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627073018",
"telephone_number": "217-753-1213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4046 MCCONNELL CT",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627073018",
"telephone_number": "217-753-1213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMER",
"first_name": "AMARETTA",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2010-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242000431",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 10348",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "16668",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL 60024121",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "104524",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22004804A",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "7814",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.