Individual provider Active NPI

Alyssa Testin, SLP

  • Speech-Language Pathologist
  • Ottawa, IL
National Provider Identifier
1417215807
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242002053 Issued in IL
Practice address
1320 State St
Ottawa, IL 61350-4413
Phone
(815) 257-1230
NPI assigned
Apr 24, 2012
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 242002053 IL Primary

Addresses

Primary practice location

1320 State St
Ottawa, IL 61350-4413

Mailing address

203 N Via Tomacelli
Toluca, IL 61369-9509

Other practice location 1

2988 Court St
Pekin, IL 61554-6229
Phone (309) 353-5940

Other identifiers 1

IdentifierTypeStateIssuer
P01134146OtherILRR MEDICARE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
242002053ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Therapy Services, Inc Speech-Language Pathologist CurrentSince Aug 1, 2012 Accepting new patients
Brendon J Johnson, OD, PC PastSince Aug 1, 2012 Accepting new patients

Locations

2900 Frank Scott Pkwy W
Ste 930
Belleville, IL 62223
Phone (618) 222-9383

1909 N Morton Ave
Morton, IL 61550
Phone (309) 263-9124

2988 Court St
Pekin, IL 61554
Phone (309) 347-5989

Organizations & group practices 2

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": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417215807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N VIA TOMACELLI",
            "city": "TOLUCA",
            "state": "IL",
            "postal_code": "613699509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 STATE ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613504413",
            "telephone_number": "815-257-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2988 Court St",
            "address_purpose": "LOCATION",
            "city": "Pekin",
            "state": "IL",
            "postal_code": "615546229",
            "country_code": "US",
            "telephone_number": "309-353-5940",
            "fax_number": "309-353-1654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TESTIN",
        "first_name": "ALYSSA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242002053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01134146",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.