Individual provider Active NPI

Laura Davis

  • Speech-Language Pathologist
  • Taylorville, IL
National Provider Identifier
1821532052
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.012603 Issued in IL
Practice address
1430 West Sunset Drive
Taylorville, IL 62568-1293
Phone
(217) 820-2423
NPI assigned
Dec 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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 146.012603 IL Primary

Addresses

Primary practice location

1430 West Sunset Drive
Taylorville, IL 62568-1293

Mailing address

1430 West Sunset Drive
Taylorville, IL 62568-1293
Phone (217) 820-2423

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220216002144 IL Practitioner - Qualified Speech Language Pathologist 2466845383 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
146.012603ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Feb 9, 2022 Accepting new patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince May 29, 2023 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Feb 9, 2022 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Feb 9, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC Speech-Language Pathologist CurrentSince Feb 9, 2022 Accepting new patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince May 29, 2023 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 6

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": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1821532052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 WEST SUNSET DRIVE",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681293",
            "telephone_number": "217-820-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 WEST SUNSET DRIVE",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681293",
            "telephone_number": "217-820-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.012603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.