Individual provider Active NPI

Virginia Gayle Jones

  • Speech-Language Pathologist
  • Lubbock, TX
National Provider Identifier
1093085250
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
19083 Issued in TX
Practice address
6502 Slide Rd Ste 204
Lubbock, TX 79424-1311
Phone
(806) 698-0864
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 19083 TX Primary

Addresses

Primary practice location

6502 Slide Rd Ste 204
Lubbock, TX 79424-1311

Mailing address

6318 10TH St
Lubbock, TX 79416-5916

Other practice location 1

601 E Tahoka Rd
Brownfield, TX 79316-3631
Phone (806) 637-6455

Other practice location 2

6502 Slide Rd Ste 204
Lubbock, TX 79424-1311
Phone (806) 698-0864

Other practice location 3

601 E Tahoka Rd
Brownfield, TX 79316-3631
Phone (806) 637-6455

Other identifiers 3

IdentifierTypeStateIssuer
207164901MedicaidTX
1093085250MedicaidTX
149984001MedicaidTX

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

LicenseStateTypeSpecialty
19083TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093085250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6318 10TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794165916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6502 SLIDE RD STE 204",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794241311",
            "telephone_number": "806-698-0864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Tahoka Rd",
            "address_purpose": "LOCATION",
            "city": "Brownfield",
            "state": "TX",
            "postal_code": "793163631",
            "country_code": "US",
            "telephone_number": "806-637-6455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6502 Slide Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794241311",
            "country_code": "US",
            "telephone_number": "806-698-0864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 E Tahoka Rd",
            "address_purpose": "LOCATION",
            "city": "Brownfield",
            "state": "TX",
            "postal_code": "793163631",
            "country_code": "US",
            "telephone_number": "806-637-6455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "VIRGINIA",
        "middle_name": "GAYLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "19083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093085250",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.