Individual provider Active NPI

Jessica Harrison, CCC-SLP

  • Speech-Language Pathologist
  • Montgomery, AL
National Provider Identifier
1346671930
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3547 Issued in AL
Practice address
2600 Vaughn Lakes Blvd
Apt 1313
Montgomery, AL 36117-4695
Phone
(205) 499-6973
NPI assigned
Dec 6, 2013
Last updated
Dec 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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 3547 AL Primary

Addresses

Primary practice location

2600 Vaughn Lakes Blvd
Apt 1313
Montgomery, AL 36117-4695

Mailing address

2600 Vaughn Lakes Blvd
Apt 1313
Montgomery, AL 36117-4695
Phone (205) 499-6973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191009001295 AL Practitioner - Qualified Speech Language Pathologist 8123359924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3547ALMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope LLC Speech-Language Pathologist CurrentSince Dec 27, 2018 Accepting new patients

Locations

1502 Main St
Greensboro, AL 36744
Phone (205) 575-1609

2703 University Blvd E
Tuscaloosa, AL 35404
Phone (205) 248-7064

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1346671930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VAUGHN LAKES BLVD",
            "address_2": "APT 1313",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361174695",
            "telephone_number": "205-499-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 VAUGHN LAKES BLVD",
            "address_2": "APT 1313",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361174695",
            "telephone_number": "205-499-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JESSICA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "3547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.