Patrice Burton-Bauman, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

203 W Main St
Rockton, IL 61072-2418

Phone

(815) 957-0099

NPI assigned

Mar 17, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Lighthouse Speech Therapy, PLLC

  • Hearing and Speech Clinic/Center
  • Rockton, IL
  • NPI 1780385559
  NPD

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1891497665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 IVY OAKS DR",
            "city": "CALEDONIA",
            "state": "IL",
            "postal_code": "610119507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W MAIN ST",
            "city": "ROCKTON",
            "state": "IL",
            "postal_code": "610722418",
            "telephone_number": "815-957-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON-BAUMAN",
        "first_name": "PATRICE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Jean Bax, OT
• Rachel Michelle Bixby, P.T.
• Board of Trustees of the University of Illinois
• Bright Start Speech and Language Services, LTD.
• Elizabeth Nicole Bunnell
• Stephanie J Carlson, DPT
• Tyler R Carroll, DPT
• Denise Clouser
• Connections Therapy Center PLLC
• Ronald Glenn Conrad I, PTA

• All providers in Rockton, IL
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.