Jennifer Wise

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SLP.6097 SPA Issued in SC

Practice address

310 Neely Ferry Road
Mauldin, SC 29662

Phone

(864) 438-0990

NPI assigned

Sep 7, 2016

Last updated

Sep 7, 2016By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Upstate Pediatric Speech Therapy Services

  • Speech-Language Pathologist
  • Mauldin, SC
  • NPI 1952693723
  NPD (past)

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1285181347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 VISTA DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296178145",
            "telephone_number": "864-404-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NEELY FERRY ROAD",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "29662",
            "telephone_number": "864-438-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "SC",
            "license": "SLP.6097 SPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlin Willett, DNP, APRN, FNP-C
• David P. Willett, MD,PA
• Latonya L Williams
• Rayvnn Williams
• Shannon Leverette Williamson, P.H.D.
• Sheila Howell Woods, M.D.
• Megan Carmichael Wooles, PA
• Youth and Family Advocacy Services
• Jennifer Elyse Zare, LISW-CP
• Stephen James Zinkann, R.P.H.

• Speech-Language Assistant in Mauldin, SC
• Providers in Mauldin, SC by specialty
• Speech-Language Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.