Individual provider Active NPI

Jayna Meyer Wettlin, MSP, CCC-SLP

  • Speech-Language Pathologist
  • Spartanburg, SC
National Provider Identifier
1104595982
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7373 Issued in SC
Practice address
128 Garner Rd
Spartanburg, SC 29303-3149
Phone
(864) 591-3484
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 7373 SC Primary

Addresses

Primary practice location

128 Garner Rd
Spartanburg, SC 29303-3149

Mailing address

440 Log Shoals Rd
Greenville, SC 29607-5012
Phone (864) 275-8956

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
7373SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Better Beginnings, Inc Multi-Specialty CurrentSince Jun 25, 2023 Accepting new patients

Locations

128 Garner Rd
Spartanburg, SC 29303
Phone (864) 591-3484

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1104595982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 LOG SHOALS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075012",
            "telephone_number": "864-275-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 GARNER RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033149",
            "telephone_number": "864-591-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTLIN",
        "first_name": "JAYNA",
        "middle_name": "MEYER",
        "name_prefix": "Mrs.",
        "credential": "MSP, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "7373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.