Individual provider Active NPI

Jennifer Akers Mitchell, MS, CCC-SLP

  • Speech-Language Pathologist
  • Jackson, MS
National Provider Identifier
1558554659
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S2367 Issued in MS
Practice address
13 Northtown Dr
Suite 110
Jackson, MS 39211-3047
Phone
(601) 206-9195
Fax
(601) 957-8391
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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 S2367 MS Primary

Addresses

Primary practice location

13 Northtown Dr
Suite 110
Jackson, MS 39211-3047

Mailing address

13 Northtown Dr
Suite 110
Jackson, MS 39211-3047
Phone (601) 206-9195

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315000575 DC Practitioner - Qualified Speech Language Pathologist 8123464922 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S2367MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Rehabilitation Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1558554659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 NORTHTOWN DR",
            "address_2": "SUITE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113047",
            "telephone_number": "601-206-9195",
            "fax_number": "601-957-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 NORTHTOWN DR",
            "address_2": "SUITE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113047",
            "telephone_number": "601-206-9195",
            "fax_number": "601-957-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JENNIFER",
        "middle_name": "AKERS",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.