Individual provider Active NPI

Amaretta Marie Gilmer, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Springfield, IL
National Provider Identifier
1205050192
Registry record updated Apr 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242000431 Issued in IL
Practice address
4046 McConnell CT
Springfield, IL 62707-3018
Phone
(217) 753-1213
NPI assigned
Apr 12, 2007
Last updated
Apr 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2010

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
16668CAMDProfessional Counselor
7814MAMDClinical Social Worker
SA 10348FLMDSpeech-Language Pathologist
242000431ILMDSpeech-Language Pathologist
22004804AINMDSpeech-Language Pathologist
104524TXMDSpeech-Language Pathologist
LL 60024121WAMDSpeech-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.

Verify at the official NPI Registry.