Active NPI
Cynthia Holloway Jourdan, CCC-SLP
- Speech-Language Pathologist
- Tupelo, MS
National Provider Identifier
1053844571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S0591
- Practice address
- 830 S Gloster St
Tupelo, MS 38801-4934 - Phone
- (662) 377-7360
- NPI assigned
- Apr 11, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | S0591 | MS | Primary |
Addresses
Primary practice location
830 S Gloster St
Tupelo, MS 38801-4934
Mailing address
3830 Water Oak CT
Saltillo, MS 38866-6898
Phone (662) 377-7360
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 |
|---|---|---|---|
| S0591 | MS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1053844571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3830 WATER OAK CT",
"city": "SALTILLO",
"state": "MS",
"postal_code": "388666898",
"telephone_number": "662-377-7360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 S GLOSTER ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388014934",
"telephone_number": "662-377-7360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOURDAN",
"first_name": "CYNTHIA",
"middle_name": "HOLLOWAY",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-11",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S0591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.