Individual provider Active NPI

Aleksandra Agnieszka Jasienska, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Stanley, NC
National Provider Identifier
1437833126
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
364 S Hwy 16
Ste 200
Stanley, NC 28164
Phone
(704) 746-9698
NPI assigned
Jun 13, 2023
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 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 NU Primary

Addresses

Primary practice location

364 S Hwy 16
Ste 200
Stanley, NC 28164

Mailing address

484 Williamson Rd Ste 102
Mooresville, NC 28117-8191

Other practice location 1

484 Williamson Rd
Suite 102
Mooresville, NC 28117
Phone (704) 746-9698

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab OT NC LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231207002966 NC Practitioner - Qualified Speech Language Pathologist 8426407024 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab SLP NC PLLCGroup PAC ID 8628427218, 8 clinicians

Practice addresses (Care Compare)

4101 Glenloch Cir
Matthews, NC 28105-6636
Phone (877) 407-3422

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Norman Communication Services, Inc. Speech-Language Pathologist CurrentSince Mar 1, 2024 Accepting new patients
Fox Rehab SLP NC PLLC Speech-Language Pathologist CurrentSince Oct 1, 2023 Accepting new patients

Locations

7505 Highway 73
Ste B
Denver, NC 28037

2008 Moore Rd
Matthews, NC 28105

484 Williamson Rd
Ste 102
Mooresville, NC 28117
Phone (704) 293-6552

364 S NC 16 Business Hwy
Ste 100
Stanley, NC 28164
Phone (720) 369-5266

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1437833126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 WILLIAMSON RD STE 102",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 S HWY 16",
            "address_2": "STE 200",
            "city": "STANLEY",
            "state": "NC",
            "postal_code": "28164",
            "telephone_number": "704-746-9698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "484 Williamson Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "28117",
            "country_code": "US",
            "telephone_number": "704-746-9698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASIENSKA",
        "first_name": "ALEKSANDRA",
        "middle_name": "AGNIESZKA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab OT NC LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2008 Moore Rd",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281054978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stanley, NC

Sources for this page

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