NPIMap

Individual provider Active NPI

Rebecca Palmer Jordan, MS, CCC/SLP

  • Speech-Language Pathologist
  • Jacksonville, NC
National Provider Identifier
1184893356
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8814 Issued in NC
Practice address
410 New Bridge Street Suite 10-a
Jacksonville, NC 28540
Phone
(910) 347-2212
Fax
(910) 347-6003
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA9157 FL
Speech-Language Pathologist 235Z00000X 8814 NC Primary

Addresses

Primary practice location

410 New Bridge Street Suite 10-a
Jacksonville, NC 28540

Mailing address

410 New Bridge Street Suite 10-a
Jacksonville, NC 28540
Phone (910) 347-2212

Other names 1

  • Rebecca Anne Palmer Former name

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

LicenseStateTypeSpecialty
SA9157FLMDSpeech-Language Pathologist
8814NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
J.Z. Mann Pediatric Therapy, Inc. Speech-Language Pathologist Past Accepting new patients
Pro Step Therapy Inc Past Accepting new patients

Organizations & group practices 2

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1184893356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 NEW BRIDGE STREET SUITE 10-A",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28540",
            "telephone_number": "910-347-2212",
            "fax_number": "910-347-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NEW BRIDGE STREET SUITE 10-A",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28540",
            "telephone_number": "910-347-2212",
            "fax_number": "910-347-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "REBECCA",
        "middle_name": "PALMER",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA9157",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "PALMER",
            "middle_name": "ANNE",
            "credential": "MS, CCC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.