Individual provider Active NPI

Karen Marie Roley, SLP

  • Speech-Language Pathologist
  • Effingham, IL
National Provider Identifier
1720105778
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.007565 Issued in IL
Practice address
1301 N Maple St
Effingham, IL 62401-1779
Phone
(217) 347-1243
Fax
(217) 347-1558
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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 146.007565 IL Primary

Addresses

Primary practice location

1301 N Maple St
Effingham, IL 62401-1779

Mailing address

1000 Health Center Dr
Mattoon, IL 61938-9253
Phone (217) 258-2525

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

LicenseStateTypeSpecialty
146.007565ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third PastSince Jan 2, 2022 Accepting new patients

Organizations & group practices 1

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1720105778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389253",
            "telephone_number": "217-258-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N MAPLE ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011779",
            "telephone_number": "217-347-1243",
            "fax_number": "217-347-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLEY",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.007565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.