Jessica Sullivan, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.015000 Issued in IL

Practice address

2300 N Edward St
Decatur, IL 62526-4192

Phone

(217) 876-2680

Fax

(217) 876-2630

NPI assigned

Apr 12, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Jessica Barton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jessicasullivan@memorial.allscriptsdirect.net
• Direct secure messaging: jessicasullivan@sfc.allscriptsdirect.net

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.

• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD

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

{
    "created_epoch": "1239494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1710120308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264192",
            "telephone_number": "217-876-2680",
            "fax_number": "217-876-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264192",
            "telephone_number": "217-876-2680",
            "fax_number": "217-876-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JESSICA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-12",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2949",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2008023621",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BARTON",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cathy Stringer-Young
• Katharine Strompolis
• Robert Lewis Stymets, MA
• Justin Sudkamp
• Randy K Sulaver II, M.D.
• Yifei Sun, M.D.
• Jennifer R Sunderland, PA-C
• Sujiththa Suntharalingam, M.D.
• Surgical Specialists of Central Illinois SC
• Ashley Swallow, LCSW

• Speech-Language Pathologist in Decatur, IL
• Providers in Decatur, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.