Active NPI
Jaclyn Pedini
- Speech-Language Pathologist
- Phoenix, AZ
National Provider Identifier
1295238202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202008265
- Practice address
- 15002 N 32ND St
Phoenix, AZ 85032-4441 - Phone
- (602) 449-2051
- NPI assigned
- Mar 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202008265 | VA | Primary |
Addresses
Primary practice location
15002 N 32ND St
Phoenix, AZ 85032-4441
Mailing address
15002 N 32ND St
Phoenix, AZ 85032-4441
Other practice location 1
13900 Hull Street Rd
Midlothian, VA 23112-2004
Phone (804) 639-8788
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202008265 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627430400000",
"number": "1295238202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15002 N 32ND ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850324441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15002 N 32ND ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850324441",
"telephone_number": "602-449-2051"
}
],
"practiceLocations": [
{
"address_1": "13900 Hull Street Rd",
"address_purpose": "LOCATION",
"city": "Midlothian",
"state": "VA",
"postal_code": "231122004",
"country_code": "US",
"telephone_number": "804-639-8788",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEDINI",
"first_name": "JACLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-15",
"last_updated": "2021-07-28",
"certification_date": "2021-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202008265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.