Active NPI
Jennifer Diane James
- Speech-Language Pathologist
- Pekin, IL
National Provider Identifier
1245758200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146006705
- Practice address
- 2447 California Rd
Pekin, IL 61554-8467 - Phone
- (309) 397-2362
- NPI assigned
- Aug 30, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 146006705 | IL | Primary |
Addresses
Primary practice location
2447 California Rd
Pekin, IL 61554-8467
Mailing address
2447 California Rd
Pekin, IL 61554-8467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146006705 | Other | IL | ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146006705 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504051200000",
"number": "1245758200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2447 CALIFORNIA RD",
"city": "PEKIN",
"state": "IL",
"postal_code": "615548467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2447 CALIFORNIA RD",
"city": "PEKIN",
"state": "IL",
"postal_code": "615548467",
"telephone_number": "309-397-2362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "JENNIFER",
"middle_name": "DIANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-30",
"last_updated": "2017-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146006705",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
"identifier": "146006705",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pekin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.