Jessica Anne Williams

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14116594 Issued in MN

Practice address

10300 Hennepin Town Rd
Eden Prairie, MN 55347-5100

Phone

(952) 444-5000

NPI assigned

Feb 26, 2024

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Active Therapy MNGroup PAC ID 2769878099, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Active Therapy MN

  • Physical Therapist
  • Eden Prairie, MN
  • NPI 1730835257

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1538925706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15667 88TH ST NE APT 222",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553302960",
            "telephone_number": "763-614-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 HENNEPIN TOWN RD",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553475100",
            "telephone_number": "952-444-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "14116594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Richard Wild, D.D.S.
• Brianna Carolyn Wilder, PA-C
• Keely Wilkie
• Kyle Wilkinson, PHARM.D
• Cassidy Williams
• Kathleen Renee Williams, DC
• Michael Williams, D.C.
• Ray Williams
• Lyle David Willock, RNFA, PA, ROPA-C
• Duane Charles Wilson, M.D.

• Speech-Language Pathologist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.