Active NPI
Ryan Kent Spicer, B.S.M.S. CCC/SLP-L
- Speech-Language Pathologist
- Flora, IL
National Provider Identifier
1841707189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.007373
- Practice address
- 445 Emory St
Flora, IL 62839-2701 - Phone
- (618) 662-2014
- NPI assigned
- Jan 9, 2018
- Sex
- Male
- Sole proprietor
- No
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 | 146.007373 | IL | Primary |
Addresses
Primary practice location
445 Emory St
Flora, IL 62839-2701
Mailing address
445 Emory St
Flora, IL 62839-2701
Phone (618) 662-2014
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.007373 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515456000000",
"number": "1841707189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 EMORY ST",
"city": "FLORA",
"state": "IL",
"postal_code": "628392701",
"telephone_number": "618-662-2014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 EMORY ST",
"city": "FLORA",
"state": "IL",
"postal_code": "628392701",
"telephone_number": "618-662-2014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPICER",
"first_name": "RYAN",
"middle_name": "KENT",
"name_prefix": "Mr.",
"credential": "B.S.M.S. CCC/SLP-L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-09",
"last_updated": "2018-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.007373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.