Active NPI
Suzann Michelle Colthurst, SLP
- Speech-Language Pathologist
- Pekin, IL
National Provider Identifier
1932492097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146009971
- Practice address
- 2988 Court St
Pekin, IL 61554-6229 - Phone
- (309) 353-5940
- Fax
- (309) 353-1654
- NPI assigned
- May 24, 2011
- Last updated
- Jan 27, 2012
- Sex
- Female
- 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 | 146009971 | IL | Primary |
Addresses
Primary practice location
2988 Court St
Pekin, IL 61554-6229
Mailing address
2988 Court St
Pekin, IL 61554-6229
Phone (309) 353-5940
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00991695 | Other | IL | RR MEDICARE |
| 537460031 | Other | IL | MEDICARE PTAN |
Other names 1
- Suzann Michelle Phelps
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 |
|---|---|---|---|
| 146009971 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brendon J Johnson, OD, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Pekin, IL
- NPI 1568647790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327622400000",
"number": "1932492097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2988 COURT ST",
"city": "PEKIN",
"state": "IL",
"postal_code": "615546229",
"telephone_number": "309-353-5940",
"fax_number": "309-353-1654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2988 COURT ST",
"city": "PEKIN",
"state": "IL",
"postal_code": "615546229",
"telephone_number": "309-353-5940",
"fax_number": "309-353-1654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLTHURST",
"first_name": "SUZANN",
"middle_name": "MICHELLE",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-24",
"last_updated": "2012-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146009971",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00991695",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "537460031",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUZANN",
"last_name": "PHELPS",
"middle_name": "MICHELLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pekin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.