Individual provider Active NPI

Jakiya Noble

  • Speech-Language Pathologist
  • Irmo, SC
National Provider Identifier
1588067136
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4198 Issued in SC
Practice address
117 Whitby Rd
Irmo, SC 29063-2426
Phone
(803) 629-4098
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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 4198 SC Primary

Addresses

Primary practice location

117 Whitby Rd
Irmo, SC 29063-2426

Mailing address

117 Whitby Rd
Irmo, SC 29063-2426
Phone (803) 629-4098

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
4198SCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1588067136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WHITBY RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632426",
            "telephone_number": "803-629-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 WHITBY RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632426",
            "telephone_number": "803-629-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "JAKIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.