Individual provider Active NPI

Stephanie Davis, SLP

  • Speech-Language Pathologist
  • Brandon, MS
National Provider Identifier
1104705201
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
920 Municipal Dr
Brandon, MS 39042-2973
Phone
(601) 724-8886
NPI assigned
Sep 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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 Primary

Addresses

Primary practice location

920 Municipal Dr
Brandon, MS 39042-2973

Mailing address

921 W Beacon St
Philadelphia, MS 39350-3229
Phone (601) 650-0002

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Therapy LLC Speech-Language Pathologist CurrentSince May 18, 2026 Accepting new patients
Performance Therapy LLC PastSince Sep 16, 2019 Accepting new patients

Locations

920 Municipal Dr
Brandon, MS 39042
Phone (601) 724-8886

1301 W Government St
Ste 104
Brandon, MS 39042
Phone (601) 591-7535

119 Colony Crossing Way
Ste 820
Madison, MS 39110
Phone (769) 289-2890

Organizations & group practices 2

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": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1104705201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W BEACON ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503229",
            "telephone_number": "601-650-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MUNICIPAL DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422973",
            "telephone_number": "601-724-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "STEPHANIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.