Jenna Broadhurst, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14292134 Issued in OR

Practice address

Oregon Veterans Home
600 N 5TH St, OR 97355

Phone

(541) 497-7265

NPI assigned

Dec 9, 2021

Last updated

Dec 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248

  OR, Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Family Medical Associates PC

  • Family Medicine Physician
  • Lebanon, OR
  • NPI 1336313923
  NPD (past)
• State of Oregon Department of Veterans' Affairs

  • Skilled Nursing Facility
  • Lebanon, OR
  • NPI 1679985113
  NPD (past)

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1225797939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NE CONIFER BLVD APT R",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973307013",
            "telephone_number": "503-810-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OREGON VETERANS HOME",
            "city": "600 N 5TH ST",
            "state": "OR",
            "postal_code": "97355",
            "telephone_number": "541-497-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADHURST",
        "first_name": "JENNA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "14292134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.