Active NPI
Jade Kiana Pearl Clark, MA CCC-SLP
- Speech-Language Pathologist
- Cincinnati, OH
National Provider Identifier
1013522523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.13998
- Practice address
- 5051 Anderson PL
Cincinnati, OH 45227-1601 - Phone
- (513) 363-2979
- NPI assigned
- Sep 11, 2020
- 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 | SP.13998 | OH | Primary |
Addresses
Primary practice location
5051 Anderson PL
Cincinnati, OH 45227-1601
Mailing address
6847 Stewart Rd Apt 425
Cincinnati, OH 45236-0718
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP.13998 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1013522523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6847 STEWART RD APT 425",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452360718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5051 ANDERSON PL",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452271601",
"telephone_number": "513-363-2979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JADE",
"middle_name": "KIANA PEARL",
"credential": "MA CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-11",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.13998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.