NPIMap

Organization Active NPI

Shine Therapy Services, LLC

  • Developmental Therapist
  • Peoria, IL
National Provider Identifier
1508214586
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Legal business name
SHINE THERAPY SERVICES, LLC
Practice address
5016 N University St
Suite 109
Peoria, IL 61614-4781
Phone
(309) 258-0084
Fax
(866) 319-1546
NPI assigned
May 31, 2016
Organization subpart
Yes
Parent organization
SHINE THERAPY SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Authorized official

Name
Sarah Ziemba, MA, CCC-SLP, OWNERNPI 1023239043
Title
Owner
Phone
(309) 258-0084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 222Q00000X Primary

Addresses

Primary practice location

5016 N University St
Suite 109
Peoria, IL 61614-4781

Mailing address

5016 N University St
Suite 109
Peoria, IL 61614-4781
Phone (309) 258-0084

National Provider Directory

National Provider Directory
Tax ID family
Shine Therapy Services LLC2 organizations share this tax ID, including this one
Part of
Shine Therapy Services LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5016 N University St
Ste 109
Peoria, IL 61614
Phone (309) 258-0084

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1508214586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 N UNIVERSITY ST",
            "address_2": "SUITE 109",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144781",
            "telephone_number": "309-258-0084",
            "fax_number": "866-319-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 N UNIVERSITY ST",
            "address_2": "SUITE 109",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144781",
            "telephone_number": "309-258-0084",
            "fax_number": "866-319-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE THERAPY SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHINE THERAPY SERVICES, LLC",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "ZIEMBA",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-258-0084",
        "authorized_official_credential": "MA, CCC-SLP, OWNER"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 31, 2016; 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.