Jillian Nicole Edgerly, CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

118427 Issued in TX

Practice address

67 S Higley Rd Ste 103-477
Gilbert, AZ 85296-1166

Phone

(480) 998-1477

NPI assigned

Jul 21, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1417520198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W 26TH ST APT 4044",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770082947",
            "telephone_number": "409-344-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 S HIGLEY RD STE 103-477",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961166",
            "telephone_number": "480-998-1477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2520 Ww Thorne Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770733406",
            "country_code": "US",
            "telephone_number": "281-985-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDGERLY",
        "first_name": "JILLIAN",
        "middle_name": "NICOLE",
        "credential": "CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.