Active NPI
Tawanna Chism, SLP
- Speech-Language Pathologist
- Jackson, TN
National Provider Identifier
1104074475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2268
- Practice address
- 48 Rampart Dr
Jackson, TN 38305-5983 - Phone
- (901) 281-8170
- NPI assigned
- Aug 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2268 | TN | Primary |
Addresses
Primary practice location
48 Rampart Dr
Jackson, TN 38305-5983
Mailing address
48 Rampart Dr
Jackson, TN 38305-5983
Phone (901) 281-8170
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2268 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1104074475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 RAMPART DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383055983",
"telephone_number": "901-281-8170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 RAMPART DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383055983",
"telephone_number": "901-281-8170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHISM",
"first_name": "TAWANNA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-28",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "2268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.