Individual provider Active NPI

Clarion Mendes, M.A. CCC-SLP/L

  • Speech-Language Pathologist
  • Champaign, IL
National Provider Identifier
1659645513
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146010435 Issued in IL
Practice address
2001 S Oak St
Champaign, IL 61820-0911
Phone
(217) 333-2205
NPI assigned
Feb 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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 146010435 IL Primary

Addresses

Primary practice location

2001 S Oak St
Champaign, IL 61820-0911

Mailing address

2001 S Oak St
Champaign, IL 61820-0911
Phone (217) 333-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514003354 IL Practitioner - Qualified Speech Language Pathologist 0547601163 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146010435ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Apr 1, 2024 Accepting new patients
University of Illinois Speech and Hearing Speech-Language Pathologist CurrentSince Apr 1, 2024 Accepting new patients

Locations

2001 S Oak St
Ste B
Champaign, IL 61820
Phone (217) 244-1806

1640 W Roosevelt Rd
#727
Chicago, IL 60608
Phone (312) 413-1871

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1659645513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S OAK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618200911",
            "telephone_number": "217-333-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S OAK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618200911",
            "telephone_number": "217-333-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDES",
        "first_name": "CLARION",
        "name_prefix": "Ms.",
        "credential": "M.A. CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146010435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.