Individual provider Active NPI

Marlene Jackson, SLPA

  • Speech-Language Assistant
  • Phoenix, AZ
National Provider Identifier
1568807717
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA8234 Issued in AZ
Practice address
5314 N 7TH St
Phoenix, AZ 85014-2805
Phone
(602) 277-5006
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA8234 AZ Primary

Addresses

Primary practice location

5314 N 7TH St
Phoenix, AZ 85014-2805

Mailing address

17103 E Cyprus Point CT
Fountain Hills, AZ 85268-5704
Phone (602) 525-3516

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

LicenseStateTypeSpecialty
SLPA8234AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1568807717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17103 E CYPRUS POINT CT",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852685704",
            "telephone_number": "602-525-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5314 N 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142805",
            "telephone_number": "602-277-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARLENE",
        "name_prefix": "Ms.",
        "credential": "SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA8234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; 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.