Individual provider Active NPI

Bethany Schimetz, MA, CCC-SLP/L

  • Speech-Language Pathologist
  • Rockford, IL
National Provider Identifier
1598313181
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.015375 Issued in IL
Practice address
501 7TH St
Rockford, IL 61104-1242
Phone
(815) 966-3000
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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 146.015375 IL Primary

Addresses

Primary practice location

501 7TH St
Rockford, IL 61104-1242

Mailing address

351 Bienterra TRL Apt 1
Rockford, IL 61107-5861

Other practice location 1

124 W 2nd St Ste A
Byron, IL 61010-1449
Phone (815) 217-9156

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146.015375ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1598313181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 BIENTERRA TRL APT 1",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 7TH ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611041242",
            "telephone_number": "815-966-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 W 2nd St Ste A",
            "address_purpose": "LOCATION",
            "city": "Byron",
            "state": "IL",
            "postal_code": "610101449",
            "country_code": "US",
            "telephone_number": "815-217-9156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHIMETZ",
        "first_name": "BETHANY",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.