Jenah Nugent-Fullam

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

110529 Issued in TX

Practice address

5034 New Forest St Apt 8309
San Antonio, TX 78229-5468

Phone

(210) 281-5401

NPI assigned

Apr 28, 2015

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1306223326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23519 ENCHANTED PATH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782604337",
            "telephone_number": "321-634-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5034 NEW FOREST ST APT 8309",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295468",
            "telephone_number": "210-281-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT-FULLAM",
        "first_name": "JENAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; 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.