Keesha L. Peterson, M. S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146-005206 Issued in IL

Practice address

1418 College Drive
Physical Medicine Department
Mount Carmel, IL 62863

Phone

(618) 263-6343

Fax

(618) 263-6477

NPI assigned

Aug 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1417147760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 COLLEGE DR",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632638",
            "telephone_number": "618-263-6343",
            "fax_number": "618-263-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 COLLEGE DRIVE",
            "address_2": "PHYSICAL MEDICINE DEPARTMENT",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "62863",
            "telephone_number": "618-263-6343",
            "fax_number": "618-263-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KEESHA",
        "middle_name": "L.",
        "credential": "M. S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003291A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146-005206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priss Parmenter, BS
• Danielle Peach, LCSW
• Kasey Leigh Pearson, PA-C
• Stephanie Dawn Perkins, MHP
• Kayla Marie Perschbacher, PA-C
• Lynn Carol Phillippe, NP
• Phillips Investments, LLC - Mt. Carmel Operations Series
• Lori Ann Phillips, NP
• Sarah Kay Pinkston, NP
• Virgil L Potts, D.C.

• Speech-Language Pathologist in Mount Carmel, IL
• Providers in Mount Carmel, 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 Jul 11, 2012; 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.