Stefanie Banks, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.012599 Issued in IL

Practice address

107 S Lincoln St
Smithton, IL 62285-1617

Phone

(618) 235-4600

NPI assigned

May 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Stefanie Lynn Shipp Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1831545540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S LINCOLN ST",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622851617",
            "telephone_number": "618-235-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S LINCOLN ST",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622851617",
            "telephone_number": "618-235-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "STEFANIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.012599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "SHIPP",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "M.S., CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Smithton, IL
• Providers in Smithton, 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 11, 2016; 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.