Jill Staffenberg, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202008842 Issued in VA

Practice address

3820 Nine Mile Rd
Richmond, VA 23223-4831

Phone

(727) 460-2502

NPI assigned

May 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jill Grossman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Henrico County Public School

  • Local Education Agency (LEA)
  • Richmond, VA
  • NPI 1598834210
  NPD (past)

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1073003133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10993 OPACA LN",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595616",
            "telephone_number": "727-460-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 NINE MILE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232234831",
            "telephone_number": "727-460-2502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3820 Nine Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232234831",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFENBERG",
        "first_name": "JILL",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "GROSSMAN",
            "credential": "MS CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stacy H. Gill, LLC
• Stacy Z. Lukanuski DDS PLC
• Magen Adeline Stacy, PT, DPT, OCS
• Carlton Stadler, MD
• Ariana Allyce Staffen, AGACNP-BC
• Josh Dwyer Stafford, PTA
• Khalilah Salaam Stafford
• Peter Joseph Stafford, M.D.
• Stagezero Life Sciences Inc
• Marykay Schorn Stainback, BS.PHARM

• Speech-Language Pathologist in Richmond, VA
• Providers in Richmond, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.