Individual provider Active NPI

Jordan Lynn Justis, M.S. C.F. SLP

  • Speech-Language Pathologist
  • Austin, TX
National Provider Identifier
1033897723
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
121282 Issued in TX
Practice address
12710 Research Blvd Ste 395
Austin, TX 78759-4397
Phone
(512) 250-8706
NPI assigned
Jul 11, 2023
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 121282 TX Primary

Addresses

Primary practice location

12710 Research Blvd Ste 395
Austin, TX 78759-4397

Mailing address

10224 Big Thicket Dr
Austin, TX 78747-2705
Phone (757) 387-0325

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 Science

State licenses

LicenseStateTypeSpecialty
121282TXMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Area Speech Therapy, PLLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1033897723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10224 BIG THICKET DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787472705",
            "telephone_number": "757-387-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 RESEARCH BLVD STE 395",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594397",
            "telephone_number": "512-250-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTIS",
        "first_name": "JORDAN",
        "middle_name": "LYNN",
        "credential": "M.S. C.F. SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "121282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.