Active NPI
Shawna Grace Stadtherr
- Speech-Language Assistant
- Montgomery, IL
National Provider Identifier
1598314072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 217000414
- Practice address
- 2925 Manchester Dr
Montgomery, IL 60538-4063 - Phone
- (630) 338-2263
- NPI assigned
- Sep 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 217000414 | IL | Primary |
Addresses
Primary practice location
2925 Manchester Dr
Montgomery, IL 60538-4063
Mailing address
2925 Manchester Dr
Montgomery, IL 60538-4063
Phone (630) 338-2263
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 217000414 | IL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567900800000",
"number": "1598314072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 MANCHESTER DR",
"city": "MONTGOMERY",
"state": "IL",
"postal_code": "605384063",
"telephone_number": "630-338-2263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2925 MANCHESTER DR",
"city": "MONTGOMERY",
"state": "IL",
"postal_code": "605384063",
"telephone_number": "630-338-2263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STADTHERR",
"first_name": "SHAWNA",
"middle_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-08",
"last_updated": "2019-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "IL",
"license": "217000414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.