Active NPI
Breanne Joleen Clair, MS, CCC-SLP
- Speech-Language Pathologist
- Decatur, IL
National Provider Identifier
1619115508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.009291
- Practice address
- 444 W Harrison Ave
Decatur, IL 62526-4157 - Phone
- (217) 877-7333
- NPI assigned
- Jan 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 Pathologist | 235Z00000X | 146.009291 | IL | Primary |
Addresses
Primary practice location
444 W Harrison Ave
Decatur, IL 62526-4157
Mailing address
3314 Ashley LN
Springfield, IL 62711-8257
Phone (575) 799-8657
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.009291 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1619115508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3314 ASHLEY LN",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627118257",
"telephone_number": "575-799-8657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 W HARRISON AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264157",
"telephone_number": "217-877-7333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAIR",
"first_name": "BREANNE",
"middle_name": "JOLEEN",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-30",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.009291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.