Jessica Ann Kavanaugh, MA.CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0000407 Issued in CO

Practice address

Hospital Americano, Base Naval de Rota
Apartado de Correos 33
Rota, CADIZ 11530
ES

Phone

(314) 727-4029

NPI assigned

Jul 15, 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 names 1

• Ms. Jessica Ann Davis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children's Speech and Reading Center

  • Speech-Language Pathologist
  • Fort Collins, CO
  • NPI 1972733202
  NPD (past)

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1114157849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 819 BOX 18",
            "city": "FPO",
            "state": "AE",
            "postal_code": "096450001"
        },
        {
            "country_code": "ES",
            "country_name": "Spain",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "HOSPITAL AMERICANO, BASE NAVAL DE ROTA",
            "address_2": "APARTADO DE CORREOS 33",
            "city": "ROTA",
            "state": "CADIZ",
            "postal_code": "11530",
            "telephone_number": "314-727-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MA.CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "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": "CO",
            "license": "0000407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DAVIS",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "MA.CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.