Active NPI
Jennette Marie Cosola, CCCSLP
- Speech-Language Pathologist
- Martinsburg, WV
National Provider Identifier
1174700017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 324
- Practice address
- 401 South Queen Street
Martinsburg, WV 25401 - Phone
- (304) 267-3500
- Fax
- (304) 267-3599
- NPI assigned
- Jan 23, 2008
- 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 | 324 | WV | Primary |
Addresses
Primary practice location
401 South Queen Street
Martinsburg, WV 25401
Mailing address
300 Yale Dr
Winchester, VA 22602
Phone (540) 722-4465
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0154440600 | Medicaid | WV |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1174700017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 YALE DR",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "22602",
"telephone_number": "540-722-4465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 SOUTH QUEEN STREET",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "25401",
"telephone_number": "304-267-3500",
"fax_number": "304-267-3599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSOLA",
"first_name": "JENNETTE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "CCCSLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-23",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0154440600",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.