Individual provider Active NPI

Morgan Rivera, M.S. CCC-SLP/L

  • Speech-Language Pathologist
  • Bloomington, IL
National Provider Identifier
1417476375
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.013140 Issued in IL
Practice address
300 E Monroe St
Bloomington, IL 61701-4028
Phone
(309) 827-6031
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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 146.013140 IL Primary

Addresses

Primary practice location

300 E Monroe St
Bloomington, IL 61701-4028

Mailing address

1612 Bryan St Apt C
Normal, IL 61761-2764
Phone (815) 716-6841

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190910001466 IL Practitioner - Qualified Speech Language Pathologist 8527397975 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
146.013140ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center CurrentSince Jul 31, 2019 Accepting new patients
CGH Medical Center CurrentSince Jul 31, 2019 Accepting new patients
Bloomington Public Schools District87 Past Accepting new patients

Locations

2600 Locust St
Ste D
Sterling, IL 61081
Phone (815) 626-3173

2600 Locust St
Sterling, IL 61081
Phone (815) 626-3173

100 E Lefevre Rd
Sterling, IL 61081
Phone (815) 625-0400

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1417476375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 BRYAN ST APT C",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612764",
            "telephone_number": "815-716-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MONROE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014028",
            "telephone_number": "309-827-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MORGAN",
        "credential": "M.S. CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.013140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.