Krystal M Allen-Jackson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP8161 Issued in OH

Practice address

15600 Parkland Dr
Shaker Heights, OH 44120

Phone

(216) 295-1400

NPI assigned

Jun 20, 2007

Last updated

Jun 7, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1083819841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13617 DREXMORE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202203",
            "telephone_number": "216-261-9600",
            "fax_number": "216-261-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 PARKLAND DR",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "44120",
            "telephone_number": "216-295-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Merit Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond Hts",
            "state": "OH",
            "postal_code": "441431457",
            "country_code": "US",
            "telephone_number": "216-261-9600 x7434",
            "fax_number": "216-261-9662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN-JACKSON",
        "first_name": "KRYSTAL",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP8161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Shaker Heights, OH
• Providers in Shaker Heights, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.