Individual provider Active NPI

Jeanette Gathman, SLP

  • Speech-Language Pathologist
  • Washington, IL
National Provider Identifier
1902160146
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
209 N Cummings Lane
Ste 824
Washington, IL 61571-2181
Phone
(309) 886-2305
Fax
(309) 444-3893
NPI assigned
Jul 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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 IL Primary

Addresses

Primary practice location

209 N Cummings Lane
Ste 824
Washington, IL 61571-2181

Mailing address

209 N Cummings Lane
Ste 824
Washington, IL 61571-2181
Phone (309) 886-2305

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1902160146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 N CUMMINGS LANE",
            "address_2": "STE 824",
            "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": "209 N CUMMINGS LANE",
            "address_2": "STE 824",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712181",
            "telephone_number": "309-886-2305",
            "fax_number": "309-444-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATHMAN",
        "first_name": "JEANETTE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.