Active NPI
Jayme Russell
- Speech-Language Assistant
- Peoria, AZ
National Provider Identifier
1003317249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA8165
- Practice address
- 25124 N 68TH Dr
Peoria, AZ 85383-7112 - Phone
- (575) 686-9605
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SLPA8165 | NM | Primary |
Addresses
Primary practice location
25124 N 68TH Dr
Peoria, AZ 85383-7112
Mailing address
25124 N 68TH Dr
Peoria, AZ 85383-7112
Phone (575) 686-9605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA8165 | NM | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1003317249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25124 N 68TH DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853837112",
"telephone_number": "575-686-9605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25124 N 68TH DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853837112",
"telephone_number": "575-686-9605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "JAYME",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "NM",
"license": "SLPA8165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.