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Miranda Mae Riddle , MS, CCC-SLP

Speech-Language Pathologist β€’ Macomb, IL

Active NPI 1407524168 Individual Practitioner Female Practitioner
Practice location in NPPES

12505 N 1500th Rd
Macomb, IL 614558425

Call 3252123239 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

12505 N 1500th Rd

Macomb, IL 614558425

Telephone 3252123239
Organization at the Same NPPES Address or Phone
Trinity Speech Services Llc Facility NPI 1538899430

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Miranda Riddle has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in Macomb and Illinois

13 active clinicians are listed under Speech-Language Pathologist with a practice address in Macomb, IL (10,226 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Macomb

0% of these 13 clinicians have the CMS telehealth indicator.

0% of these 13 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-01-12
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES IL 146.016080

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

License # reported to NPPES IL 146016080

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

License # reported to NPPES TX 114598

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - QUALIFIED SPEECH LANGUAGE PATHOLOGIST

Medicare Enrollment ID

I20230831004834

Enrollment State Jurisdiction

FL

PECOS Control ID

1355708926

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location January 12, 2023

Registered at 12505 N 1500TH RD, MACOMB, IL 614558425 (Tel: 3252123239)

πŸ“
Updated Business Mailing Address January 12, 2023

Registered at 12505 N 1500TH RD, MACOMB, IL 614558425 (Tel: 3252123239)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 12, 2023

Speech-Language Pathologist (license number reported to NPPES: IL 146016080)

βœ…
NPI Profile Active August 30, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 30, 2021

Registered at 202 N REED ST, INDUSTRY, IL 614405169 (Tel: 3252123239)

πŸ“
Business Mailing Address (Initial Record) August 30, 2021

Registered at 202 N REED ST, INDUSTRY, IL 614405169 (Tel: 3252123239)

πŸ‘€
Provider Name / Credentials (Initial Record) August 30, 2021

Recorded as MIRANDA RIDDLE, MS., CCC-SLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 30, 2021

Speech-Language Pathologist (license number reported to NPPES: IL 146.016080)

🟒
Initial NPI Registration & Enumeration August 30, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1407524168
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 30, 2021
Last Update: January 12, 2023
Sole Proprietor: Yes

Mailing Address

12505 N 1500th Rd

Macomb, IL 614558425

Phone: 3252123239

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.