Individual provider Active NPI

Jenna Grogan, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Towson, MD
National Provider Identifier
1316684251
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
02362L Issued in MD
Practice address
6901 N Charles St
Towson, MD 21204-3780
Phone
(410) 887-1100
NPI assigned
May 12, 2022
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 Pathologist 235Z00000X 02362L MD Primary

Addresses

Primary practice location

6901 N Charles St
Towson, MD 21204-3780

Mailing address

401 Cormorant PL
3207
Frederick, MD 21701
Phone (443) 605-7246

Other names 1

  • Jenna Utz Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
02362LMDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1316684251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CORMORANT PL",
            "address_2": "3207",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "443-605-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 N CHARLES ST",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212043780",
            "telephone_number": "410-887-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN",
        "first_name": "JENNA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "02362L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "UTZ",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.