Active NPI
Jessica Ann Jacobson, CF-SLP
- Speech-Language Pathologist
- Boulder, CO
National Provider Identifier
1306685128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- PSLP.0001294
- Practice address
- 4960 Meredith Way Apt 102
Boulder, CO 80303-9122 - Phone
- (904) 229-6280
- NPI assigned
- May 21, 2024
- 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 | PSLP.0001294 | CO | Primary |
Addresses
Primary practice location
4960 Meredith Way Apt 102
Boulder, CO 80303-9122
Mailing address
4960 Meredith Way Apt 102
Boulder, CO 80303-9122
Phone (904) 229-6280
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 |
|---|---|---|---|
| PSLP.0001294 | CO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716249600000",
"number": "1306685128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4960 MEREDITH WAY APT 102",
"city": "BOULDER",
"state": "CO",
"postal_code": "803039122",
"telephone_number": "904-229-6280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4960 MEREDITH WAY APT 102",
"city": "BOULDER",
"state": "CO",
"postal_code": "803039122",
"telephone_number": "904-229-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "JESSICA",
"middle_name": "ANN",
"credential": "CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-21",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "PSLP.0001294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.