Individual provider Active NPI

Peyton Michele Wright

  • Speech-Language Pathologist
  • Belleville, IL
National Provider Identifier
1932684636
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.004787 Issued in IL
Practice address
727 N 17TH St
Belleville, IL 62226-6552
Phone
(217) 690-5723
NPI assigned
Sep 27, 2018
Last updated
Jan 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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 242.004787 IL Primary

Addresses

Primary practice location

727 N 17TH St
Belleville, IL 62226-6552

Mailing address

945 Dere Bere Dr
Mascoutah, IL 62258-1339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190523001264 IL Practitioner - Qualified Speech Language Pathologist 4880937309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
242.004787ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Speech-Language Pathologist CurrentSince Jun 2, 2021 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Jun 2, 2021 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince May 20, 2019 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince May 20, 2019 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1932684636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 DERE BERE DR",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622581339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N 17TH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622266552",
            "telephone_number": "217-690-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "PEYTON",
        "middle_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.