NPIMap

Organization Active NPI

JCS Rehabilitation & Wellness Center,PLLC

  • Speech-Language Pathologist
  • Aberdeen, NC
National Provider Identifier
1497085252
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8637 Issued in NC
Legal business name
JCS REHABILITATION & WELLNESS CENTER,PLLC
Practice address
1902 N Sandhills Blvd
Suite B
Aberdeen, NC 28315-2382
Phone
(910) 215-7155
Fax
(910) 944-5901
NPI assigned
Dec 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Authorized official

Name
Jerry Lee Jones, MS,CCC-SLP
Title
Speech-Language Pathologist
Phone
(910) 215-7155

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 7235 NC
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 2301 NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 8637 NC Primary

Addresses

Primary practice location

1902 N Sandhills Blvd
Suite B
Aberdeen, NC 28315-2382

Mailing address

1902 N Sandhills Blvd
Suite D
Aberdeen, NC 28315-2382
Phone (910) 215-7155

Other identifiers 1

IdentifierTypeStateIssuer
7413676MedicaidNC

National Provider Directory

National Provider Directory

Locations

1902 N Sandhills Blvd
Ste D
Aberdeen, NC 28315
Phone (910) 215-7155

NPI Registry JSON

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1497085252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 N SANDHILLS BLVD",
            "address_2": "SUITE D",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283152382",
            "telephone_number": "910-215-7155",
            "fax_number": "910-944-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 N SANDHILLS BLVD",
            "address_2": "SUITE B",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283152382",
            "telephone_number": "910-215-7155",
            "fax_number": "910-944-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCS REHABILITATION & WELLNESS CENTER,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "910-215-7155",
        "authorized_official_credential": "MS,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "7235",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "2301",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7413676",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.