Individual provider Active NPI

Jennifer Visker

  • Speech-Language Pathologist
  • Kent, OH
National Provider Identifier
1083965560
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP. 7574 Issued in OH
Practice address
1325 Theatre Dr A104
Kent, OH 44242-3001
Phone
(330) 672-2674
NPI assigned
Sep 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP. 7574 OH Primary

Addresses

Primary practice location

1325 Theatre Dr A104
Kent, OH 44242-3001

Mailing address

83 Outlook Dr
Tallmadge, OH 44278-1927

Other practice location 1

225 S Main St
Rm. 181, Polsky Building
Akron, OH 44325-3001
Phone (330) 972-2120

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

LicenseStateTypeSpecialty
SP. 7574OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kent State University CurrentSince Feb 1, 2025 Accepting new patients

Locations

1325 Theatre Dr A126 Ctr For The Performing Arts
Kent, OH 44242
Phone (330) 672-0250

1325 Theatre Dr
Kent, OH 44242
Phone (330) 672-0259

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.

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1083965560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 OUTLOOK DR",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 THEATRE DR A104",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442423001",
            "telephone_number": "330-672-2674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 S Main St",
            "address_2": "Rm. 181, Polsky Building",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443253001",
            "country_code": "US",
            "telephone_number": "330-972-2120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISKER",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP. 7574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.