Active NPI
Jessica L Pettit, M.S. CCC-SLP
- Speech-Language Pathologist
- Miamisburg, OH
National Provider Identifier
1184764748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 7246
- Practice address
- 540 Park Ave
Miamisburg, OH 45342-2854 - Phone
- (937) 866-3381
- NPI assigned
- Feb 6, 2007
- 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 | SP 7246 | OH | Primary |
Addresses
Primary practice location
540 Park Ave
Miamisburg, OH 45342-2854
Mailing address
10209 Feather CT
Miamisburg, OH 45342-0831
Phone (937) 859-6731
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 7246 | OH | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miamisburg City Schools | Past | Accepting new patients |
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.
-
- Local Education Agency (LEA)
- Miamisburg, OH
- NPI 1326245994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1184764748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10209 FEATHER CT",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453420831",
"telephone_number": "937-859-6731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 PARK AVE",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453422854",
"telephone_number": "937-866-3381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIT",
"first_name": "JESSICA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP 7246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miamisburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.