Gina Thomas

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

401 N Park Ave
Chatham, IL 62629-1164

Phone

(217) 483-4490

NPI assigned

Apr 10, 2019

Last updated

Apr 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Live Well Counseling Services

  • Clinical Social Worker
  • Venedy, IL
  • NPI 1881055838
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1215490958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 GARDEN CT",
            "city": "CHATHAM",
            "state": "IL",
            "postal_code": "626291721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N PARK AVE",
            "city": "CHATHAM",
            "state": "IL",
            "postal_code": "626291164",
            "telephone_number": "217-483-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627117917",
            "country_code": "US",
            "telephone_number": "217-787-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 S. Main St",
            "address_purpose": "LOCATION",
            "city": "Chatham",
            "state": "IL",
            "postal_code": "62629",
            "country_code": "US",
            "telephone_number": "217-697-5415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christianna Lynn Sullivan, LCSW LCPC
• Kendra Lynn Sullivan, FNP-BC
• Maurice Eugene Sullivan III, D.C.
• Sunlight Counseling Services, PLLC
• John Bryan Taylor, D.C.
• Grace Ann Thomas, PHARMACIST
• Donna Joann Thurston, LCPC
• Time 2 Talk, LLC
• Katrina Toran, LCPC
• Kristina Waggoner, FNP

• Speech-Language Pathologist in Chatham, IL
• Providers in Chatham, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.