Active NPI
Jessica Sargent
- Speech-Language Pathologist
- Southfield, MI
National Provider Identifier
1053767707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101005809
- Practice address
- 24111 Civic Center Dr
Southfield, MI 48033-7414 - Phone
- (248) 349-9595
- NPI assigned
- May 12, 2016
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 9667 | NC | |
| Speech-Language Pathologist | 235Z00000X | 7101005809 | MI | Primary |
Addresses
Primary practice location
24111 Civic Center Dr
Southfield, MI 48033-7414
Mailing address
517 W Genesee St
Frankenmuth, MI 48734-1312
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9667 | NC | MD | Dentist |
| 7101005809 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578960000000",
"number": "1053767707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 W GENESEE ST",
"city": "FRANKENMUTH",
"state": "MI",
"postal_code": "487341312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24111 CIVIC CENTER DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480337414",
"telephone_number": "248-349-9595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARGENT",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-12",
"last_updated": "2020-01-14",
"certification_date": "2020-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "9667",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101005809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.