Angela Sudholt, TAYLOR

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146009797 Issued in IL

Practice address

3393 Venhaus Rd
Trenton, IL 62293-3220

Phone

(618) 741-7226

NPI assigned

Jul 12, 2012

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

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • O Fallon, IL
  • NPI 1982018362

  Speech-Language Pathologist

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1457616625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3393 VENHAUS RD",
            "city": "TRENTON",
            "state": "IL",
            "postal_code": "622933220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 VENHAUS RD",
            "city": "TRENTON",
            "state": "IL",
            "postal_code": "622933220",
            "telephone_number": "618-741-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDHOLT",
        "first_name": "ANGELA",
        "credential": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146009797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roots&Renewal, PLLC
• Nancy Lynn Schubert-Henss, RPH
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde
• Steven J. Stone, DDS
• Steven J. Stone, D.D.S.
• Sugar Creek Emergency Services District
• The Residential Developers, Inc.
• Dana Leigh Trame, FNP
• Trenton Chiropractic Clinic LTD
• Trenton Eye Care, PLLC

• Speech-Language Pathologist in Trenton, IL
• Providers in Trenton, 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 12, 2012; 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.