Active NPI
Jessica Newby
- Speech-Language Pathologist
- Fairfax, VA
National Provider Identifier
1124487483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202008059
- Practice address
- 4315 Chain Bridge Rd
Fairfax, VA 22030-3061 - Phone
- (703) 934-5092
- NPI assigned
- Feb 15, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202008059 | VA | Primary |
| Speech-Language Pathologist | 235Z00000X | 000984 | DC | |
| Speech-Language Pathologist | 235Z00000X | 07633 | MD |
Addresses
Primary practice location
4315 Chain Bridge Rd
Fairfax, VA 22030-3061
Mailing address
4315 Chain Bridge Rd
Fairfax, VA 22030-3061
Phone (703) 934-5092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000984 | DC | MD | Speech-Language Pathologist |
| 07633 | MD | MD | Speech-Language Pathologist |
| 2202008059 | VA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bal Therapy LLC | Speech-Language Pathologist | Current | Accepting new patients |
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": "1455494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455494400000",
"number": "1124487483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4315 CHAIN BRIDGE RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220303061",
"telephone_number": "703-934-5092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4315 CHAIN BRIDGE RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220303061",
"telephone_number": "703-934-5092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBY",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-15",
"last_updated": "2016-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202008059",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "DC",
"license": "000984",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "07633",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.