Individual provider Active NPI

Jessica Bonner

  • Speech-Language Pathologist
  • Birmingham, AL
National Provider Identifier
1174403497
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4858 Issued in AL
Practice address
529 Beacon Pkwy W Ste 101
Birmingham, AL 35209-3126
Phone
(205) 440-2294
Fax
(205) 850-5571
NPI assigned
Sep 5, 2025
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 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 4858 AL Primary

Addresses

Primary practice location

529 Beacon Pkwy W Ste 101
Birmingham, AL 35209-3126

Mailing address

6209 Windsor LN
Pinson, AL 35126-3490
Phone (205) 440-2294

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
4858ALMDEducational Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anointed by Grace Designs, LLC Speech-Language Pathologist CurrentSince Sep 8, 2025 Accepting new patients

Locations

529 Beacon Pkwy W
Ste 101
Birmingham, AL 35209
Phone (205) 440-2294

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1174403497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 WINDSOR LN",
            "city": "PINSON",
            "state": "AL",
            "postal_code": "351263490",
            "telephone_number": "205-440-2294",
            "fax_number": "205-850-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BEACON PKWY W STE 101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352093126",
            "telephone_number": "205-440-2294",
            "fax_number": "205-850-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "4858",
            "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 Sep 5, 2025; 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.