Jennifer Christine Edwards-Mayes, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12031896 Issued in MI

Practice address

8245 Holly Rd
Suite 204
Grand Blanc, MI 48439

Phone

(810) 603-0040

Fax

(810) 603-0044

NPI assigned

Mar 19, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1104067206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8245 HOLLY RD",
            "address_2": "SUITE 204",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392443",
            "telephone_number": "810-603-0040",
            "fax_number": "810-603-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8245 HOLLY RD",
            "address_2": "SUITE 204",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-603-0040",
            "fax_number": "810-603-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS-MAYES",
        "first_name": "JENNIFER",
        "middle_name": "CHRISTINE",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "12031896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA ID NUMBER",
            "identifier": "12031896",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Edilberto Moreno MD PC
• Radhika Lakshmi Edpuganti, DO
• Akrum Eidelsafy, BCBA, LBA
• Eden Eisenbeis
• Timothy Ephriam Ekpo, DO
• Malak N El-Saghir, BEHAVIORAL TECH
• Saly Elias

• Speech-Language Pathologist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.