Jenna Davis, MS CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

105071 Issued in TX

Practice address

17301 N Interstate 35 Ste 101
Buda, TX 78610-5249

Phone

(512) 994-4115

Fax

(512) 777-5042

NPI assigned

Oct 27, 2017

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Maciel 2 LLC

  dba Little Land New Braunfels

  • Early Intervention Provider Agency
  • New Braunfels, TX
  • NPI 1598469637

  Speech-Language Pathologist

  NPD (past)
• Maciel, LLC

  • Early Intervention Provider Agency
  • Buda, TX
  • NPI 1225562184

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1184136301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17301 N INTERSTATE 35 STE 101",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786105249",
            "telephone_number": "512-994-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17301 N INTERSTATE 35 STE 101",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786105249",
            "telephone_number": "512-994-4115",
            "fax_number": "512-777-5042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17301 N Interstate 35 Ste 101",
            "address_purpose": "LOCATION",
            "city": "Buda",
            "state": "TX",
            "postal_code": "786105249",
            "country_code": "US",
            "telephone_number": "512-994-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNA",
        "credential": "MS CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLP",
            "identifier": "105071",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CVS Pharmacy Inc (CVS Pharmacy #10535)
• D.Tox Lymphatic Drainage LLC (Flourish Baby Pediatric Therapy)
• D&S Residential Services, LP (Sun Bonnet Community Residence)
• Martin Dean Danner
• Brittany Lynne Davis, L.AC.
• Monica Shavon Davis, FNP
• Vivian De la Fuentes
• D'Vaughn W Delpit, LCSW
• Natalie Demendonca-Rosales
• Dental Health Associates of Texas, PC (Budaful Dental Care)

• Speech-Language Pathologist in Buda, TX
• Providers in Buda, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.