Individual provider Active NPI

Jayne R McManigal

  • Speech-Language Pathologist
  • Prescott, AZ
National Provider Identifier
1407110836
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLPL5761 Issued in AZ
Practice address
2900 W Crestview Dr
Prescott, AZ 86305-7007
Phone
(928) 420-6971
NPI assigned
Jun 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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 SLPL5761 AZ Primary

Addresses

Primary practice location

2900 W Crestview Dr
Prescott, AZ 86305-7007

Mailing address

2900 W Crestview Dr
Prescott, AZ 86305-7007
Phone (928) 420-6971

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
SLPL5761AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1407110836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W CRESTVIEW DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057007",
            "telephone_number": "928-420-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W CRESTVIEW DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057007",
            "telephone_number": "928-420-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANIGAL",
        "first_name": "JAYNE",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLPL5761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.