Active NPI
Jamie Selvidio, MS, CCC-SLP
- Speech-Language Pathologist
- Beverly, MA
National Provider Identifier
1013108497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7149
- Practice address
- 100 Cummings Ctr
Suite 135H
Beverly, MA 01915-6115 - Phone
- (978) 927-0172
- Fax
- (978) 927-0179
- NPI assigned
- Aug 9, 2007
- Sex
- Female
- Sole proprietor
- No
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 Pathologist | 235Z00000X | 7149 | MA | Primary |
Addresses
Primary practice location
100 Cummings Ctr
Suite 135H
Beverly, MA 01915-6115
Mailing address
100 Cummings Ctr
Suite 135H
Beverly, MA 01915-6115
Phone (978) 927-0172
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12127595 | Other | MA | ASHA |
| 7149 | Other | MA | MASS. STATE LICENSE |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7149 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Verbal ABA Clinic, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1013108497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CUMMINGS CTR",
"address_2": "SUITE 135H",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019156115",
"telephone_number": "978-927-0172",
"fax_number": "978-927-0179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CUMMINGS CTR",
"address_2": "SUITE 135H",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019156115",
"telephone_number": "978-927-0172",
"fax_number": "978-927-0179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELVIDIO",
"first_name": "JAMIE",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "7149",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA",
"identifier": "12127595",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS. STATE LICENSE",
"identifier": "7149",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.