Active NPI
Victoria Winn, ST
- Speech-Language Pathologist
- Peoria, IL
National Provider Identifier
1437278538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146-003143
- Practice address
- 900 Main St
Ste 450
Peoria, IL 61602-1005 - Phone
- (309) 672-4568
- Fax
- (309) 672-4569
- NPI assigned
- Mar 28, 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 | 146-003143 | IL | Primary |
Addresses
Primary practice location
900 Main St
Ste 450
Peoria, IL 61602-1005
Mailing address
900 Main St
Ste 450
Peoria, IL 61602-1005
Phone (309) 672-4568
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00931262 | Other | IL | RR 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
| License | State | Type | Specialty |
|---|---|---|---|
| 146-003143 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326412800000",
"number": "1437278538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 MAIN ST",
"address_2": "STE 450",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021005",
"telephone_number": "309-672-4568",
"fax_number": "309-672-4569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MAIN ST",
"address_2": "STE 450",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021005",
"telephone_number": "309-672-4568",
"fax_number": "309-672-4569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINN",
"first_name": "VICTORIA",
"credential": "ST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2012-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146-003143",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00931262",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.