Active NPI
Monique A Conner, M.S.,CCC-SLP
- Speech-Language Pathologist
- South Bend, IN
National Provider Identifier
1205901568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22002570A
- Practice address
- 100 Navarre PL
Suite 6650
South Bend, IN 46601-1156 - Phone
- (574) 647-1350
- Fax
- (574) 647-1351
- NPI assigned
- Nov 22, 2006
- 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 | 22002570A | IN | Primary |
Addresses
Primary practice location
100 Navarre PL
Suite 6650
South Bend, IN 46601-1156
Mailing address
328 N Michigan St
Suite 200
South Bend, IN 46601-1244
Phone (574) 647-1842
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 |
|---|---|---|---|
| 22002570A | IN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Health System, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205901568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 N MICHIGAN ST",
"address_2": "SUITE 200",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011244",
"telephone_number": "574-647-1842",
"fax_number": "574-647-1825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NAVARRE PL",
"address_2": "SUITE 6650",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011156",
"telephone_number": "574-647-1350",
"fax_number": "574-647-1351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNER",
"first_name": "MONIQUE",
"middle_name": "A",
"credential": "M.S.,CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22002570A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.