Active NPI
Sadie Rose Allen
- Speech-Language Pathologist
- Champaign, IL
National Provider Identifier
1205495397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 4112 Fieldstone Rd.
Champaign, IL 61822 - Phone
- (888) 308-3728
- NPI assigned
- Jun 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
4112 Fieldstone Rd.
Champaign, IL 61822
Mailing address
6620 W 900 S-90
Warren, IN 46792-9543
Phone (765) 499-7224
Other practice location 1
11988 Mark Twain Ln
Bridgeton, MO 63044-2825
Phone (314) 291-8240
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": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1205495397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6620 W 900 S-90",
"city": "WARREN",
"state": "IN",
"postal_code": "467929543",
"telephone_number": "765-499-7224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4112 FIELDSTONE RD.",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61822",
"telephone_number": "888-308-3728"
}
],
"practiceLocations": [
{
"address_1": "11988 Mark Twain Ln",
"address_purpose": "LOCATION",
"city": "Bridgeton",
"state": "MO",
"postal_code": "630442825",
"country_code": "US",
"telephone_number": "314-291-8240",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALLEN",
"first_name": "SADIE",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-11",
"last_updated": "2021-04-09",
"certification_date": "2021-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.