Individual provider Active NPI

Stephanie Barb

  • Speech-Language Pathologist
  • East Peoria, IL
National Provider Identifier
1952844094
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.004913 Issued in IL
Practice address
411 E Washington St
East Peoria, IL 61611-2663
Phone
(309) 282-6704
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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 146.004913 IL Primary

Addresses

Primary practice location

411 E Washington St
East Peoria, IL 61611-2663

Mailing address

214 E Surrey LN
East Peoria, IL 61611-5434
Phone (309) 369-6236

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

LicenseStateTypeSpecialty
146.004913ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1952844094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E SURREY LN",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616115434",
            "telephone_number": "309-369-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E WASHINGTON ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112663",
            "telephone_number": "309-282-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARB",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.004913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.