Individual provider Active NPI

Jessica Marie Gottschick, MS, CCC-SLP

  • Speech-Language Pathologist
  • West Chester, OH
National Provider Identifier
1164107587
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7095 Issued in TN
Practice address
5531 Chappell Crossing Blvd
West Chester, OH 45069-5226
Phone
(877) 407-3422
NPI assigned
Jun 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 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 7095 TN Primary

Addresses

Primary practice location

5531 Chappell Crossing Blvd
West Chester, OH 45069-5226

Mailing address

2011 Richard Jones Rd Apt P10
Nashville, TN 37215-2863
Phone (440) 665-4757

Other practice location 1

2011 Richard Jones Rd Apt P10
Nashville, TN 37215-2863
Phone (440) 665-4757

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services OH, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230724001149 TN Practitioner - Qualified Speech Language Pathologist 0345600250 Reassigns benefits to 1 organization
I20241203004457 OH Practitioner - Qualified Speech Language Pathologist 0345600250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fox Rehabilitation Services Oh, LLCGroup PAC ID 1254698350, 142 clinicians

Practice addresses (Care Compare)

6525 N High St
Worthington, OH 43085-4045
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7095TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Jul 3, 2023 Accepting new patients
Fox Rehabilitation Services Oh, LLC Speech-Language Pathologist CurrentSince Nov 1, 2024 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Jul 3, 2023 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

7 Carnegie Plz
Cherry Hill, NJ 08003

6525 N High St
Worthington, OH 43085
Phone (332) 230-2813

Organizations & group practices 3

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": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1164107587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 RICHARD JONES RD APT P10",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152863",
            "telephone_number": "440-665-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5531 CHAPPELL CROSSING BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450695226",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2011 Richard Jones Rd Apt P10",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372152863",
            "country_code": "US",
            "telephone_number": "440-665-4757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTSCHICK",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "7095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services OH, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "5531 Chappell Crossing Blvd",
            "city": "West Chester",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450695226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.