Individual provider Active NPI

Jen Vice

  • Speech-Language Pathologist
  • Ashland, KY
National Provider Identifier
1134675648
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
175167 Issued in KY
Practice address
1100 Our Ladys Way Ste 228
Ashland, KY 41101-7049
Phone
(740) 200-0742
NPI assigned
Aug 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP.12827 OH
Speech-Language Pathologist 235Z00000X 175167 KY Primary

Addresses

Primary practice location

1100 Our Ladys Way Ste 228
Ashland, KY 41101-7049

Mailing address

1100 Our Ladys Way Ste 228
Ashland, KY 41101-7049

Other practice location 1

522 Glenwood Ave
#165
New Boston, OH 45662-5505
Phone (740) 354-7761

Other practice location 2

2801 Adams St
Ashland, KY 41102-6007
Phone (606) 465-9754

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
175167KYMDSpeech-Language Pathologist
SP.12827OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Interactive Therapy Services CurrentSince Aug 4, 2024 Accepting new patients

Locations

1100 Our Ladys Way
Ste 228
Ashland, KY 41101
Phone (740) 200-0742

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": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1134675648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 OUR LADYS WAY STE 228",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 OUR LADYS WAY STE 228",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017049",
            "telephone_number": "740-200-0742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "522 Glenwood Ave",
            "address_2": "#165",
            "address_purpose": "LOCATION",
            "city": "New Boston",
            "state": "OH",
            "postal_code": "456625505",
            "country_code": "US",
            "telephone_number": "740-354-7761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 Adams St",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411026007",
            "country_code": "US",
            "telephone_number": "606-465-9754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICE",
        "first_name": "JEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.12827",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "175167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.