Individual provider Active NPI

Gabrielle Nelson

  • Speech-Language Pathologist
  • Rockford, IL
National Provider Identifier
1609478205
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
5222 Spring Creek Rd
Rockford, IL 61114-6330
Phone
(815) 654-4960
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 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 Primary

Addresses

Primary practice location

5222 Spring Creek Rd
Rockford, IL 61114-6330

Mailing address

6167 Parish PL
Rockford, IL 61109-4127
Phone (815) 874-1636

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

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1609478205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6167 PARISH PL",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611094127",
            "telephone_number": "815-874-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 SPRING CREEK RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146330",
            "telephone_number": "815-654-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "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 Nov 10, 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.