Individual provider Active NPI

Juliette Chamberlain

  • Speech-Language Pathologist
  • Iowa City, IA
National Provider Identifier
1205444585
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
101237 Issued in IA
Practice address
540 E Jefferson St Ste 302
Iowa City, IA 52245-2460
Phone
(319) 339-3611
Fax
(319) 339-3878
NPI assigned
Jul 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 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 101237 IA Primary

Addresses

Primary practice location

540 E Jefferson St Ste 302
Iowa City, IA 52245-2460

Mailing address

1130 S Scott Blvd Ste 1
Iowa City, IA 52240-2909
Phone (319) 569-2969

Other identifiers 1

IdentifierTypeStateIssuer
06-65463MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address juliette.chamberlain@mercyic.org

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

State licenses

LicenseStateTypeSpecialty
101237IAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy of Iowa CurrentSince Oct 29, 2023 Accepting new patients
Progressive Rehabilitation Associates L.L.C. CurrentSince Aug 2, 2020 Accepting new patients

Locations

540 E Jefferson St
Ste 302
Iowa City, IA 52245
Phone (319) 339-3611

1130 S Scott Blvd
Ste 1
Iowa City, IA 52240
Phone (319) 354-2429

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": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1205444585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S SCOTT BLVD STE 1",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402909",
            "telephone_number": "319-569-2969",
            "fax_number": "319-338-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E JEFFERSON ST STE 302",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452460",
            "telephone_number": "319-339-3611",
            "fax_number": "319-339-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "JULIETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "101237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06-65463",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "juliette.chamberlain@mercyic.org",
            "affiliation": "N",
            "address_1": "540 E Jefferson St Ste 302",
            "city": "Iowa City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "522452460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.