Active NPI
Jessica Marie McMath
- Student in an Organized Health Care Education/Training Program
- Clovis, NM
National Provider Identifier
1043737869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1600 Sutter PL
Clovis, NM 88101-4611 - Phone
- (575) 769-4490
- NPI assigned
- Aug 23, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary | ||
| Speech-Language Pathologist | 235Z00000X | CF7239 | NM |
Addresses
Primary practice location
1600 Sutter PL
Clovis, NM 88101-4611
Mailing address
1600 Sutter PL
Clovis, NM 88101-4611
Other practice location 1
1500 S Ave K
Station 3, SHROC
Portales, NM 88130
Phone (575) 562-2160
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 |
|---|---|---|---|
| CF7239 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern New Mexico University | 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.
-
- Speech-Language Pathologist
- Portales, NM
- NPI 1356115273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1043737869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SUTTER PL",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881014611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SUTTER PL",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881014611",
"telephone_number": "575-769-4490"
}
],
"practiceLocations": [
{
"address_1": "1500 S Ave K",
"address_2": "Station 3, SHROC",
"address_purpose": "LOCATION",
"city": "Portales",
"state": "NM",
"postal_code": "88130",
"country_code": "US",
"telephone_number": "575-562-2160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCMATH",
"first_name": "JESSICA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "CF7239",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.