Active NPI
Lynn Ann Martie, MS CCC-SLP
- Speech-Language Pathologist
- Chenoa, IL
National Provider Identifier
1780833988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146002354
- Practice address
- 24588 Church St
Chenoa, IL 61726-9395 - Phone
- (309) 747-2702
- Fax
- (309) 747-5238
- NPI assigned
- Sep 11, 2008
- 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 | 146002354 | IL | Primary |
Addresses
Primary practice location
24588 Church St
Chenoa, IL 61726-9395
Mailing address
1201 N Cummings LN
Washington, IL 61571-2181
Phone (309) 886-2305
Other practice location 1
1501 Mercy Creek Dr
Normal, IL 61761-9597
Phone (309) 747-2702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 537460041 | Other | IL | MEDICARE PTAN |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146002354 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1780833988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 N CUMMINGS LN",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615712181",
"telephone_number": "309-886-2305",
"fax_number": "309-444-3893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24588 CHURCH ST",
"city": "CHENOA",
"state": "IL",
"postal_code": "617269395",
"telephone_number": "309-747-2702",
"fax_number": "309-747-5238"
}
],
"practiceLocations": [
{
"address_1": "1501 Mercy Creek Dr",
"address_purpose": "LOCATION",
"city": "Normal",
"state": "IL",
"postal_code": "617619597",
"country_code": "US",
"telephone_number": "309-747-2702",
"fax_number": "309-747-5238",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIE",
"first_name": "LYNN",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MS CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-11",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146002354",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "537460041",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chenoa, IL
- Amanda K Krutke, FNP-BC
- Tanya L Landrus
- Lavender Rose Dental
- Letitride Inc (Chenoa Rx LTC)
- Letitride Inc (Chenoa rx)
- Meadows Mennonite Retirement Community (Show Bus Meadows)
- Meadows Mennonite Retirement Community Association, Inc. (Meadows Mennonite Home)
- Jeffrey Medema, ST
- Lesley Caroline Milam
- Anna Margaret Rodriguez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.