Individual provider Active NPI

Jessica M Young, MS/SLP

  • Speech-Language Pathologist
  • Stuart, VA
National Provider Identifier
1396014510
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006038 Issued in VA
Practice address
4423 Moorefield Store Rd
Stuart, VA 24171-4729
Phone
(276) 692-6882
NPI assigned
Dec 16, 2011
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 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 2202006038 VA Primary

Addresses

Primary practice location

4423 Moorefield Store Rd
Stuart, VA 24171-4729

Mailing address

716 Wood Brothers Dr
Stuart, VA 24171-1406
Phone (276) 694-4488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240817000108 VA Practitioner - Qualified Speech Language Pathologist 3476091745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

716 Wood Brothers Dr
Stuart, VA 24171-1406
Phone (276) 694-4488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202006038VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chatterbox Speech and Language Therapy, LLC Speech-Language Pathologist CurrentSince May 13, 2024 Accepting new patients
Chatterbox Speech and Language Therapy, LLC CurrentSince May 13, 2024 Accepting new patients

Locations

716 Wood Brothers Dr
Stuart, VA 24171
Phone (276) 694-4488

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": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1396014510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 WOOD BROTHERS DR",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241711406",
            "telephone_number": "276-694-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 MOOREFIELD STORE RD",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241714729",
            "telephone_number": "276-692-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "MS/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.