Active NPI
Jennilyn Evans, CCC-SLP
- Speech-Language Pathologist
- Valley View, TX
National Provider Identifier
1568129088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 108954
- Practice address
- 802 S Lee St
Valley View, TX 76272-7625 - Phone
- (940) 665-0773
- NPI assigned
- Nov 18, 2021
- Last updated
- Nov 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 108954 | TX | Primary |
Addresses
Primary practice location
802 S Lee St
Valley View, TX 76272-7625
Mailing address
PO Box 764
Valley View, TX 76272-0764
Phone (940) 641-2194
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108954 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1568129088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 764",
"city": "VALLEY VIEW",
"state": "TX",
"postal_code": "762720764",
"telephone_number": "940-641-2194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 S LEE ST",
"city": "VALLEY VIEW",
"state": "TX",
"postal_code": "762727625",
"telephone_number": "940-665-0773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JENNILYN",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-18",
"last_updated": "2021-11-18",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "108954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley View, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.