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Deactivated NPI 1558883215 Deactivated / Inactive NPI Female Practitioner

Kierstyn B Green

Speech-Language Pathologist • Effingham, IL

✓ Accepts Medicare Assignment
⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kierstyn Green has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 13, 2017
NPI Deactivation Date June 08, 2018
Total Practice Duration ~1 Years of Practice (2017 – 2018)

Professional Overview & Biography Verified Profile Summary

Kierstyn Green was a registered Speech-Language Pathologist practicing in Effingham, IL. Throughout an active medical career spanning 1 years, Kierstyn Green provided care at the practice location at 2803 S BANKER ST until profile deactivation on 2018-06-08.

Kierstyn Green was affiliated with Empowerme Rehabilitation Illinois Llc and accepted Medicare assignment.

Historical Medicare Part B clinical services included treatment of speech, language, voice, communication, and/or hearing processing disorder, evaluation of speech sound production with evaluation of language comprehension and expression. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

2803 S Banker St

Effingham, IL 624012978

Telephone 2175401500
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Effingham, IL

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
9 Yrs -4.0 yrs vs City Avg
City Avg: 13.0 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
19 Specialists

Practicing in Effingham, IL (10321 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
53.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Green (9 Years) 9 Yrs
Effingham Specialty Average (13.0 Years) 13.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92507 Treatment of speech, language, voice, communication, and/or hearing processing disorder
285 15 $159.00 $73.29

Medical Specialties & State Licenses

CMS Verified: 2020-10-01
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License IL 146014216

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.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License MO 2017023547

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.

Hospital & Practice Group Affiliations

Empowerme Rehabilitation Illinois Llc

7108 Marine Rd, Edwardsville, IL 620254282

Phone: 6187069759

Secondary Practice Locations

634 N Main St Ste 3

O Fallon, IL 62269

Phone: 6186324222

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Leah Snyder

Behavior Analyst

NPI 1497441794
Dr. David Greene , DDS

Dentist - General Practice

NPI 1750511192

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location October 01, 2020

Registered at 2803 S BANKER ST, EFFINGHAM, IL 624012978 (Tel: 2175401500)

📍
Updated Business Mailing Address October 01, 2020

Registered at 9995 N COUNTRY DR, EFFINGHAM, IL 624014710 (Tel: 2178212153)

📍
Updated Business Mailing Address September 17, 2019

Registered at 1011 N MARTIN ST, EFFINGHAM, IL 624011747 (Tel: 2178212153)

📍
Updated Practice Location July 26, 2018

Registered at 634 N MAIN ST STE 3, O FALLON, IL 62269 (Tel: 6186324222)

📍
Updated Business Mailing Address July 26, 2018

Registered at 506 PARK HILLS DR, EFFINGHAM, IL 624013118

👤
Provider Name / Credentials Updated July 26, 2018

Recorded as KIERSTYN GREEN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2018

Speech-Language Pathologist (License #2017023547 in MO)

⚠️
NPI Profile Deactivated June 08, 2018

Record deactivated on June 08, 2018

NPI Profile Active July 13, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location July 13, 2017

Registered at 16216 BAXTER RD STE 330, CHESTERFIELD, MO 630174778 (Tel: (636) 733-3330)

📍
Updated Business Mailing Address July 13, 2017

Registered at 16216 BAXTER RD STE 330, CHESTERFIELD, MO 630174778 (Tel: 6367333330)

👤
Provider Name / Credentials Updated July 13, 2017

Recorded as KIERSTYN BONE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2017

Speech-Language Pathologist (License #2017023547 in MO)

🟢
Initial NPI Registration & Enumeration July 13, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1558883215
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 13, 2017
Last Update: October 01, 2020
Deactivation Date: June 08, 2018
Sole Proprietor: Yes

Mailing Address

9995 N Country Dr

Effingham, IL 624014710

Phone: 2178212153

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.