Individual provider Active NPI

Jessica Blankenship

  • Speech-Language Pathologist
  • South Bloomfield, OH
National Provider Identifier
1336972652
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
COND.20242868-SP Issued in OH
Practice address
194 Dowler Dr
South Bloomfield, OH 43103-9239
Phone
(740) 983-5003
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 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 COND.20242868-SP OH Primary

Addresses

Primary practice location

194 Dowler Dr
South Bloomfield, OH 43103-9239

Mailing address

5014 Pettibone PL
South Bloomfield, OH 43103-3505
Phone (740) 412-2085

Other practice location 1

7150 Ashville Fairfield Rd
Ashville, OH 43103-9406
Phone (740) 983-5000

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
COND.20242868-SPOHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1336972652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5014 PETTIBONE PL",
            "city": "SOUTH BLOOMFIELD",
            "state": "OH",
            "postal_code": "431033505",
            "telephone_number": "740-412-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 DOWLER DR",
            "city": "SOUTH BLOOMFIELD",
            "state": "OH",
            "postal_code": "431039239",
            "telephone_number": "740-983-5003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7150 Ashville Fairfield Rd",
            "address_purpose": "LOCATION",
            "city": "Ashville",
            "state": "OH",
            "postal_code": "431039406",
            "country_code": "US",
            "telephone_number": "740-983-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND.20242868-SP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bloomfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.