Individual provider Active NPI

Jasmine Stevenson

  • Speech-Language Pathologist
  • Glendale, AZ
National Provider Identifier
1275727091
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP4238 Issued in AZ
Practice address
5125 N 58TH Ave
Glendale, AZ 85301-7453
Phone
(623) 931-5800
NPI assigned
Sep 5, 2007
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP4238 AZ Primary

Addresses

Primary practice location

5125 N 58TH Ave
Glendale, AZ 85301-7453

Mailing address

5447 E Janice Way
Scottsdale, AZ 85254-8211
Phone (520) 241-6584

Other identifiers 1

IdentifierTypeStateIssuer
814063MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811002592 AZ Practitioner - Qualified Speech Language Pathologist 5294139366 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Mountain Therapy LLC Speech-Language Pathologist CurrentSince May 1, 2025 Accepting new patients
Empowerme Rehabilitation, LLC Speech-Language Pathologist CurrentSince Feb 1, 2024 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Jun 5, 2023 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Jun 5, 2023 Accepting new patients
Empowerme Rehabilitation, LLC Speech-Language Pathologist CurrentSince Feb 1, 2024 Accepting new patients

Locations

7370 E Gold Dust Ave
Rm 212
Scottsdale, AZ 85258
Phone (602) 816-3924

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

110 Horizon Dr
#310
Raleigh, NC 27615

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1275727091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 E JANICE WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852548211",
            "telephone_number": "520-241-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017453",
            "telephone_number": "623-931-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "814063",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.