Individual provider Active NPI

Jessica Lush

  • Speech-Language Assistant
  • Salem, OR
National Provider Identifier
1194377804
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
A0165 Issued in OR
Practice address
1475 Capitol St NE
Salem, OR 97301-7850
Phone
(971) 599-1712
Fax
(888) 835-4257
NPI assigned
Jul 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X A0165 OR Primary

Addresses

Primary practice location

1475 Capitol St NE
Salem, OR 97301-7850

Mailing address

1017 Hermitage Way S Apt 15
Salem, OR 97302-5098

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
A0165ORMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sensible Speech-Language Pathology, Inc PastSince Jan 22, 2018 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.

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1194377804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 HERMITAGE WAY S APT 15",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017850",
            "telephone_number": "971-599-1712",
            "fax_number": "888-835-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSH",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "OR",
            "license": "A0165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.