Active NPI
Katheryn Kleiss, MA, CCC SLP
- Speech-Language Pathologist
- Urbana, IL
National Provider Identifier
1295854107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146008630
- Practice address
- 810 W Anthony Dr
Urbana, IL 61802-7431 - Phone
- (217) 326-2911
- Fax
- (217) 344-8047
- NPI assigned
- Mar 29, 2007
- 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 | 146008630 | IL | Primary |
Addresses
Primary practice location
810 W Anthony Dr
Urbana, IL 61802-7431
Mailing address
611 W Park St
Fapc
Urbana, IL 61801-2500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113326 | Other | HEALTHLINK PROV ID | |
| 203 | Other | IL | BLUE CROSS PROV ID |
| 4117 | Other | IL | HAMP PROVIDER ID |
| 7216 | Other | PERSONALCARE PROV ID |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146008630 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Carle Foundation Hospital | 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.
-
- Rehabilitation Hospital Unit
- Urbana, IL
- NPI 1619034659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1295854107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"address_2": "FAPC",
"city": "URBANA",
"state": "IL",
"postal_code": "618012500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 W ANTHONY DR",
"city": "URBANA",
"state": "IL",
"postal_code": "618027431",
"telephone_number": "217-326-2911",
"fax_number": "217-344-8047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEISS",
"first_name": "KATHERYN",
"name_prefix": "Ms.",
"credential": "MA, CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146008630",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK PROV ID",
"identifier": "113326",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROV ID",
"identifier": "203",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAMP PROVIDER ID",
"identifier": "4117",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONALCARE PROV ID",
"identifier": "7216",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.