Individual provider Active NPI

Jazmin C Berrios, SLP

  • Speech-Language Pathologist
  • El Paso, TX
National Provider Identifier
1366063430
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
115955 Issued in TX
Practice address
2150 Trawood Dr Ste A100
El Paso, TX 79935-3383
Phone
(915) 333-0200
Fax
(915) 792-0576
NPI assigned
Apr 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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 115955 TX Primary

Addresses

Primary practice location

2150 Trawood Dr Ste A100
El Paso, TX 79935-3383

Mailing address

2150 Trawood Dr Ste A100
El Paso, TX 79935-3383
Phone (915) 333-0200

Other practice location 1

444 Executive Center Blvd
El Paso, TX 79902-1058
Phone (915) 242-2190

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL clinicsource.com

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
115955TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1366063430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 TRAWOOD DR STE A100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353383",
            "telephone_number": "915-333-0200",
            "fax_number": "915-792-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 TRAWOOD DR STE A100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353383",
            "telephone_number": "915-333-0200",
            "fax_number": "915-792-0576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Executive Center Blvd",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799021058",
            "country_code": "US",
            "telephone_number": "915-242-2190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRIOS",
        "first_name": "JAZMIN",
        "middle_name": "C",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "115955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clinicsource.com",
            "affiliation": "N",
            "address_1": "2150 Trawood Dr Ste A100",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799353383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.