Active NPI
Courtney Anderson
- Speech-Language Pathologist
- Jackson, MS
National Provider Identifier
1306261946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S3819
- Practice address
- 5880 Ridgewood Rd
Apt Q137
Jackson, MS 39211-2695 - Phone
- (601) 503-7277
- NPI assigned
- Feb 18, 2014
- 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 | S3819 | MS | Primary |
Addresses
Primary practice location
5880 Ridgewood Rd
Apt Q137
Jackson, MS 39211-2695
Mailing address
5880 Ridgewood Rd
Apt Q137
Jackson, MS 39211-2695
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7600 Chevy Chase Dr
Suite 300
Austin, TX 78752-1503
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S3819 | MS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1306261946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5880 RIDGEWOOD RD",
"address_2": "APT Q137",
"city": "JACKSON",
"state": "MS",
"postal_code": "392112695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5880 RIDGEWOOD RD",
"address_2": "APT Q137",
"city": "JACKSON",
"state": "MS",
"postal_code": "392112695",
"telephone_number": "601-503-7277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-18",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S3819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.