Individual provider Active NPI

Jenna Dietrich, M.A, CCC-SLP

  • Speech-Language Pathologist
  • Quincy, IL
National Provider Identifier
1316725450
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.007181 Issued in IL
Practice address
4634 Cortez Dr
Quincy, IL 62305-4402
Phone
(217) 430-6865
NPI assigned
Sep 19, 2023
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.007181 IL Primary

Addresses

Primary practice location

4634 Cortez Dr
Quincy, IL 62305-4402

Mailing address

4634 Cortez Dr
Quincy, IL 62305-4402
Phone (217) 440-0898

Other names 1

  • Jenna Marie Zanger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031003538 IL Practitioner - Qualified Speech Language Pathologist 1456707181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
242.007181ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Speech-Language Pathologist CurrentSince Oct 17, 2023 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Oct 17, 2023 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Oct 17, 2023 Accepting new patients
Sprout Therapy Services Speech-Language Pathologist CurrentSince Jun 29, 2025 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Oct 17, 2023 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1421 W 10th St
Metropolis, IL 62960
Phone (618) 312-7300

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6765

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1316725450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4634 CORTEZ DR",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623054402",
            "telephone_number": "217-440-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4634 CORTEZ DR",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623054402",
            "telephone_number": "217-430-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "JENNA",
        "credential": "M.A, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.007181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "ZANGER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.