MS. BRENDA M WILSON (NPI# 1215054507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215054507 |
| Entity Type | Individual |
| Full Name | MS. BRENDA M WILSON |
| Credential | CCC |
| Practice Address |
200 Lerna Rd S Mattoon IL 61938-9388 |
| Mailing Address |
611 W Park St Urbana IL 61801-2500 |
| Practice Telephone | 2172583640 |
| Practice Fax Number | 2172583460 |
| Mailing Telephone | 2173262911 |
| Mailing Fax Number | 2173448047 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | IL | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HAMP PROV ID | 4117 | 01 |
| HEALTHLINK PROV ID | 113326 | 01 | |
| IL | BLUE CROSS PROV ID | 203 | 01 |
| PERSONALCARE PROV ID | 7216 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407471402 | Brenda June Wilson | Nurse Practitioner | 8609 Sw 58th Cir, Oklahoma City, OK 73179-7910 | 2020-06-15 |
| 1578082764 | Brenda Louise Wilson | Technician | 1200 Delaware Ave Sw Apt 704, Washington, DC 20024-3926 | 2017-09-19 |
| 1932655123 | Brenda Wilson | Physician Assistant | 2418 Allegheny Way, Placentia, CA 92870-1404 | 2016-08-29 |
| 1750793485 | Brenda Joyce Wilson | Home Health Aide | 791 E 156th St, Cleveland, OH 44110-3069 | 2014-05-29 |
| 1710252663 | Brenda Lynn Wilson | Massage Therapist | 1390 Oak St Ste 5, Eugene, OR 97401-3567 | 2012-03-11 |
| 1528367653 | Brenda Michelle Wilson | Counselor | 229 Pollard Rd, Northbridge, MA 01534-1063 | 2011-03-15 |
| 1326379819 | Brenda Joyce Wilson | Counselor | 30 C Street N. E., Miami, OK 74354-3361 | 2010-01-22 |
| 1689895146 | Brenda Marie Wilson | Counselor | Manatee Service Center, 600 301 Blvd - Suite 144, Bradenton, FL 34205 | 2007-05-01 |
| 1720100464 | Brenda Wilson | Physical Therapist | 100 Robert H. Fiser Dr., Morrilton, AR 72110 | 2007-04-04 |
| 1972130037 | Brenda Louise Wilson | Social Worker | 1008 E Jefferson St, Charlottesville, VA 22902-5328 | 2020-03-26 |
| Street Address |
200 LERNA RD S |
| City | MATTOON |
| State | IL |
| Zip Code | 61938-9388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568413490 | Paula C Mcnitt | Psychologist | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2006-05-15 |
| 1336796028 | Melanie Y Sparks | Physical Therapist | 200 Lerna Rd S, Mattoon, IL 61938-9300 | 2019-08-19 |
| 1124320700 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2010-12-02 |
| 1215254297 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2010-04-29 |
| 1447580774 | Jamie L Forsythe | Nurse Practitioner | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2010-01-08 |
| 1821218934 | Jean M Smitley | Speech-Language Pathologist | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2007-04-30 |
| 1720107626 | Barbara Hunter | Occupational Therapist | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2007-03-29 |
| 1376662502 | Toni C Chambers | Speech-Language Pathologist | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2007-03-28 |
| 1801912167 | Mark Masse | Physical Therapist | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2007-03-21 |
| 1568588838 | Sara N Masse | Physical Therapist | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2007-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
| Find all providers in zip 61938 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619477528 | Angela Lynn Owen | Speech-Language Pathologist | 1709 S 9th St, Mattoon, IL 61938-6000 | 2018-02-16 |
| 1821509159 | Jill Bolin | Speech-Language Pathologist | 1201 S 6th St, Mattoon, IL 61938-5830 | 2017-10-13 |
| 1013436526 | Natasha Renee Ruholl | Speech-Language Pathologist | 1000 Health Ctr Drive, Mattoon, IL 61938-0372 | 2017-09-15 |
| 1033656194 | Sarah Elizabeth Nolan | Speech-Language Pathologist | 1200 Bell Ave, Mattoon, IL 61938-6027 | 2017-01-27 |
| 1568875391 | Carrie Ann Miller | Speech-Language Pathologist | 709 N 12th St, Mattoon, IL 61938-3130 | 2014-06-10 |
| 1992136121 | Danell Ann Condron | Speech-Language Pathologist | 4201 Western Ave, Mattoon, IL 61938-2049 | 2013-12-13 |
| 1548694383 | Lisa G Clark | Speech-Language Pathologist | 2405 Champaign Ave, Mattoon, IL 61938-2646 | 2013-08-28 |
| 1376986422 | Cassie Deann Flack | Speech-Language Pathologist | 3308 Chestnut Ave, Mattoon, IL 61938-3615 | 2013-04-08 |
| 1437461191 | Amy J Clark | Speech-Language Pathologist | 3609 Western Ave, Mattoon, IL 61938-2040 | 2010-07-10 |
| 1881810638 | Christina Michelle Booker | Speech-Language Pathologist | 35 Sugar Creek Ln, Mattoon, IL 61938-8467 | 2007-04-18 |
| Find all providers in MATTOON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.