Individual provider Active NPI

Jennifer Taylor, MA, CCC-SLP

  • Speech-Language Pathologist
  • Mansfield, OH
National Provider Identifier
1447735345
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
COND.2018865-SP Issued in OH
Practice address
700 S Illinois Ave
Mansfield, OH 44907-1835
Phone
(419) 522-4319
NPI assigned
Sep 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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 COND.2018865-SP OH Primary

Addresses

Primary practice location

700 S Illinois Ave
Mansfield, OH 44907-1835

Mailing address

700 S Illinois Ave
Mansfield, OH 44907-1835
Phone (419) 522-4319

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250617001839 MI Practitioner - Qualified Speech Language Pathologist 8527579549 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COND.2018865-SPOHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Issa Speech Therapy PLLC CurrentSince Apr 11, 2025 Accepting new patients

Locations

2900 Golfside Dr
Ste 6
Ann Arbor, MI 48108
Phone (734) 224-9121

5245 Schaefer Rd
Ste D
Dearborn, MI 48126
Phone (248) 862-5311

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1447735345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S ILLINOIS AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071835",
            "telephone_number": "419-522-4319",
            "fax_number": "419-526-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S ILLINOIS AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071835",
            "telephone_number": "419-522-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND.2018865-SP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.