Individual provider Active NPI

Jessica Sanders

  • Speech-Language Assistant
  • Casa Grande, AZ
National Provider Identifier
1306608633
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA15030 Issued in AZ
Practice address
220 W Kortsen Rd
Casa Grande, AZ 85122-5910
Phone
(520) 836-2111
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA15030 AZ Primary

Addresses

Primary practice location

220 W Kortsen Rd
Casa Grande, AZ 85122-5910

Mailing address

1197 E Avenida Ellena
Casa Grande, AZ 85122-1106
Phone (520) 483-7344

Other practice location 1

1197 E Avenida Ellena
Casa Grande, AZ 85122-1106
Phone (520) 483-7344

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

LicenseStateTypeSpecialty
SLPA15030AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1306608633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1197 E AVENIDA ELLENA",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221106",
            "telephone_number": "520-483-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W KORTSEN RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225910",
            "telephone_number": "520-836-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1197 E Avenida Ellena",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851221106",
            "country_code": "US",
            "telephone_number": "520-483-7344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA15030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.