Jennifer Jackson Wilson, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0000001403 Issued in TN

Practice address

1600 Peyton Manning
Knoxville, TN 37996

Phone

(865) 974-5451

Fax

(865) 974-4639

NPI assigned

Apr 7, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Fox Rehabilitation Services TN LLCGroup PAC ID 8921363771, 73 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fox Rehabilitation Services TN LLC

  • Physical Therapist
  • Spring Hill, TN
  • NPI 1710406491

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1033232913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PEYTON MANNING PASS",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379960001",
            "telephone_number": "865-974-5451",
            "fax_number": "865-974-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PEYTON MANNING",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37996",
            "telephone_number": "865-974-5451",
            "fax_number": "865-974-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "JACKSON",
        "name_prefix": "Ms.",
        "credential": "M.A.  CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000001403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Wilson, CRNA
• Jasmine Wilson
• Jennifer Wilson, LPN
• Jennifer Wilson
• Jennifer Danielle Wilson, B.S.
• Jennifer R Wilson, R.N.
• John Wilson III, CPRS
• Julia E Wilson, LMFT
• Kimberly Shannon Wilson, PHD
• Kristina Wilson

• Speech-Language Pathologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.