Michelle Kay Garris, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146006677 Issued in IL

Practice address

4732 Patriots Dr
Scott Air Force Base, IL 62225-1197

Phone

(618) 746-4738

NPI assigned

May 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1447873542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 AARON DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203065",
            "telephone_number": "618-234-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 PATRIOTS DR",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "622251197",
            "telephone_number": "618-746-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIS",
        "first_name": "MICHELLE",
        "middle_name": "KAY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146006677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin M Cox
• Anick Diessongo
• Sheila Bonnie Durlester, PNP
• Cheryl Lynn Frietch, R.D.
• Leeann Jeanette Funk, LCSW
• Joseph William Glovacz Jr., PHARM.D.
• Sarah Nicole Gore, O.D.
• Jennifer Renee Hardin, CNS
• Jeffrey Roger Herchler, APA-C
• Terese (Terri) Ann Hoef, RDH

• Speech-Language Pathologist in Scott Air Force Base, IL
• Providers in Scott Air Force Base, 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 May 22, 2020; 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.