Jessica N Vanderway, M.S. CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242.005334 Issued in IL

Practice address

1925 S Main St
Bloomington, IL 61704-7313

Phone

(515) 978-6755

NPI assigned

Jun 18, 2019

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

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Fox Rehabilitation Services Il LLC

  • Physical Therapist
  • Westchester, IL
  • NPI 1114443462

  Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1992365290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 GOLFCREST RD S APT 4",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616044",
            "telephone_number": "630-890-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 S MAIN ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047313",
            "telephone_number": "515-978-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWAY",
        "first_name": "JESSICA",
        "middle_name": "N",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.005334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tana Van Meter, PT,DPT
• Stacey Karzen Van Scoyoc, DDS
• Tracy L Vanapeldoorn, APRN, FNP-C
• David Arlen Vancoppenolle, P.T.
• William K. Vanderwaal, D.D.S.
• Jesse L Vanle, M.D.
• John Peter Vanscoyoc, DDS
• Clara Varlese, LCPC,NCC
• Rajeev Varma, MD
• Sharon Anna Varughese

• Speech-Language Pathologist in Bloomington, IL
• Providers in Bloomington, 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 Jun 18, 2019; 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.