Individual provider Active NPI

Jessica Rae Zwirn, M.A. SLP-CCC

  • Speech-Language Pathologist
  • Kennebunk, ME
National Provider Identifier
1518230762
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1940 Issued in ME
Practice address
3 Brazier LN
Kennebunk, ME 04043-7095
Phone
(207) 985-3030
NPI assigned
Feb 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 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 SP1940 ME Primary

Addresses

Primary practice location

3 Brazier LN
Kennebunk, ME 04043-7095

Mailing address

5 Wainwright Ave
Kittery, ME 03904-1227
Phone (603) 285-5275

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP1940MEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1518230762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WAINWRIGHT AVE",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041227",
            "telephone_number": "603-285-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BRAZIER LN",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040437095",
            "telephone_number": "207-985-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWIRN",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "credential": "M.A. SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-20",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP1940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.