Andrea Kaye Grotefendt, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.009486 Issued in IL

Practice address

708 Saint Louis St
Edwardsville, IL 62025-1427

Phone

(618) 799-9062

NPI assigned

Jul 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edwardsville Cusd7

  • Local Education Agency (LEA)
  • Edwardsville, IL
  • NPI 1346469103
  NPD (past)

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1982181178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8875 FRUIT RD",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620256603",
            "telephone_number": "618-799-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 SAINT LOUIS ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251427",
            "telephone_number": "618-799-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTEFENDT",
        "first_name": "ANDREA",
        "middle_name": "KAYE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.009486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Grace Gregory
• Ashley Kate Griffin
• Gabrielle Anne Griffin, DPT
• Rileigh M Griffin, DPT
• Kate Elizabeth Griffith, RBT
• John Joseph Gruber, RPH, CGP, FASCP
• Jingshu Guan
• Katherine Gullick
• Roger Gunther, LCSW
• Theresa Marie Haase, SRNA

• Speech-Language Pathologist in Edwardsville, IL
• Providers in Edwardsville, 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 Jul 20, 2018; 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.