Jenna Wilson, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP010194 Issued in GA

Practice address

477 Prominence CT Ste 100
Dawsonville, GA 30534-6377

Phone

(401) 216-9564

NPI assigned

May 20, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jenna Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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 and National Provider Directory roles.

• Prosper Therapy Services, LLC

  • Pediatric Occupational Therapist
  • Dawsonville, GA
  • NPI 1720660152

  Speech-Language Pathologist

  NPD
• Kidztherapy Networks Inc

  • Pediatric Occupational Therapist
  • Cumming, GA
  • NPI 1700913522

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1548827165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 STANDING ROCK RD",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302761405",
            "telephone_number": "404-925-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 PROMINENCE CT STE 100",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346377",
            "telephone_number": "401-216-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "SMITH",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ken Whitlow, PT
• Melissa Dora Wilcox, D.C.
• Wildwood Eye Care LLC
• Madison Williams, FNP-C
• Sarah Williamson, PA
• Meagan Wilson, NP-C
• Daniel Scott Winter, OD
• Women'S Imaging Specialists - Dawsonville, LLC
• Vance T Wood, PSYD
• Sara Anne Woodland

• Speech-Language Pathologist in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.