Progress to Success Speech Therapy PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PROGRESS TO SUCCESS SPEECH THERAPY PLLC

Practice address

4940 Wilderness PT
Smithton, IL 62285-3664

Phone

(618) 719-1582

NPI assigned

Oct 19, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelsey Sullivan, M.S., CCC-SLPNPI 1346506789

Title

Authorized Official

Phone

(618) 719-1582

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelsey Sullivan, CCC-SLP

  • Speech-Language Pathologist
  • Glen Carbon, IL
  • NPI 1346506789
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1942809231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 WILDERNESS PT",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622853664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 WILDERNESS PT",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622853664",
            "telephone_number": "618-719-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESS TO SUCCESS SPEECH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "618-719-1582",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "contact@kelseysullivanspeechtherapy.net",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4940 Wilderness Pt",
            "city": "Smithton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622853664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jamie Rhiannan Petty, LMT
• Amy Y Pfingsten
• Margaret Recker
• Abby Marie Reinneck, PHARMD.
• Tracie Ellen Sandheinrich, LPC, MT-BC
• Christopher Schenewerk, MD
• Small Talk Speech Therapy, Inc.

• Speech-Language Pathologist in Smithton, IL
• Providers in Smithton, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.