Individual provider Active NPI

Alexandra Marie Jones, M.S., CF-SLP

  • Speech-Language Pathologist
  • Peoria, IL
National Provider Identifier
1780155697
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242005171 Issued in IL
Practice address
2315 N Sterling Ave
Peoria, IL 61604-3124
Phone
(309) 672-6557
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 242005171 IL Primary

Addresses

Primary practice location

2315 N Sterling Ave
Peoria, IL 61604-3124

Mailing address

3121 N Isabell Ave
Peoria, IL 61604-1358
Phone (309) 453-5755

Other identifiers 1

IdentifierTypeStateIssuer
242005171MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250528003296 IL Practitioner - Qualified Speech Language Pathologist 7214456649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242005171ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Augustana College Single Specialty CurrentSince May 19, 2025 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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1780155697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 N ISABELL AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041358",
            "telephone_number": "309-453-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 N STERLING AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043124",
            "telephone_number": "309-672-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S., CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242005171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242005171",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.