Individual provider Active NPI

Bridgette L. Vale, SLP

  • Speech-Language Pathologist
  • Galesburg, IL
National Provider Identifier
1457798076
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.011574 Issued in IL
Practice address
872 W Dayton St
Galesburg, IL 61401-1503
Phone
(309) 344-3400
Fax
(309) 344-3401
NPI assigned
May 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 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 146.011574 IL Primary

Addresses

Primary practice location

872 W Dayton St
Galesburg, IL 61401-1503

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Other names 1

  • Bridgette L Kranz Former name

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
002293IAMDOccupational Therapist
146.011574ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1457798076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 W DAYTON ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011503",
            "telephone_number": "309-344-3400",
            "fax_number": "309-344-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALE",
        "first_name": "BRIDGETTE",
        "middle_name": "L.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.011574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGETTE",
            "last_name": "KRANZ",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.