Active NPI
Jourdon H Russell, SLP
- Speech-Language Pathologist
- Spring, TX
National Provider Identifier
1013408798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S4422
- Practice address
- 9450 Grogans Mill Rd Ste 150
Spring, TX 77380-3666 - Phone
- (832) 616-3075
- NPI assigned
- May 29, 2018
- 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 | S4422 | MS | Primary |
Addresses
Primary practice location
9450 Grogans Mill Rd Ste 150
Spring, TX 77380-3666
Mailing address
9450 Grogans Mill Rd Ste 150
Spring, TX 77380-3666
Phone (832) 616-3075
Other practice location 1
2106 S Tate St Ste E
Corinth, MS 38834-7913
Phone (662) 643-4043
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 |
|---|---|---|---|
| S4422 | MS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anchor Rehabilitation LLC | Speech-Language Pathologist | 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": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628640000000",
"number": "1013408798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9450 GROGANS MILL RD STE 150",
"city": "SPRING",
"state": "TX",
"postal_code": "773803666",
"telephone_number": "832-616-3075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9450 GROGANS MILL RD STE 150",
"city": "SPRING",
"state": "TX",
"postal_code": "773803666",
"telephone_number": "832-616-3075"
}
],
"practiceLocations": [
{
"address_1": "2106 S Tate St Ste E",
"address_purpose": "LOCATION",
"city": "Corinth",
"state": "MS",
"postal_code": "388347913",
"country_code": "US",
"telephone_number": "662-643-4043",
"fax_number": "662-643-4044",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "JOURDON",
"middle_name": "H",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-29",
"last_updated": "2021-08-11",
"certification_date": "2021-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S4422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.