Active NPI
Jenny Ellison, M.S., CCC-SLP
- Speech-Language Pathologist
- Birmingham, AL
National Provider Identifier
1114493863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2363
- Practice address
- 200 One Nineteen Blvd
Birmingham, AL 35242-7236 - Phone
- (800) 401-6335
- NPI assigned
- Oct 21, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 2363 | AL | Primary |
Addresses
Primary practice location
200 One Nineteen Blvd
Birmingham, AL 35242-7236
Mailing address
2094 Chelsea Ridge Dr
Columbiana, AL 35051-3380
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2363 | AL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540080000000",
"number": "1114493863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2094 CHELSEA RIDGE DR",
"city": "COLUMBIANA",
"state": "AL",
"postal_code": "350513380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ONE NINETEEN BLVD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352427236",
"telephone_number": "800-401-6335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "JENNY",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-21",
"last_updated": "2018-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "2363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.