Active NPI
Siedah Austin
- Speech-Language Pathologist
- Jackson, MS
National Provider Identifier
1326428764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S3711
- Practice address
- 4836 Chastain Dr
Jackson, MS 39206-5062 - Phone
- (601) 454-4877
- NPI assigned
- Jun 1, 2015
- Last updated
- Jun 1, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | S3711 | MS | Primary |
Addresses
Primary practice location
4836 Chastain Dr
Jackson, MS 39206-5062
Mailing address
4836 Chastain Dr
Jackson, MS 39206-5062
Phone (601) 454-4877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12150448 | Other | MD | AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION |
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 |
|---|---|---|---|
| S3711 | MS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1326428764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4836 CHASTAIN DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392065062",
"telephone_number": "601-454-4877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4836 CHASTAIN DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392065062",
"telephone_number": "601-454-4877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "SIEDAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-01",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S3711",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
"identifier": "12150448",
"state": "MD"
}
],
"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 Jun 1, 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.