Active NPI
Rachel W Anderson, MS CCC-SLP
- Speech-Language Pathologist
- Jackson, MS
National Provider Identifier
1598095754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S3417
- Practice address
- 4500 I-55 N
Suite 291, Highland Village
Jackson, MS 39211-5930 - Phone
- (601) 362-0859
- Fax
- (601) 362-0870
- NPI assigned
- Jan 11, 2010
- Sex
- Female
- Sole proprietor
- No
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 | S3417 | MS | Primary |
Addresses
Primary practice location
4500 I-55 N
Suite 291, Highland Village
Jackson, MS 39211-5930
Mailing address
4500 I-55 North
Suite 291, Highland Village
Jackson, MS 39211
Phone (601) 362-0859
Other practice location 1
950 E County Line Rd Ste E
Ridgeland, MS 39157-1928
Phone (601) 853-9747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S3417 | Other | MS | MISSISSIPPI STATE DEPARTMENT OF HEALTH LICENSE |
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)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drayer Physical Therapy Mississippi LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Crystal Springs, MS
- NPI 1801333521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1598095754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 I-55 NORTH",
"address_2": "SUITE 291, HIGHLAND VILLAGE",
"city": "JACKSON",
"state": "MS",
"postal_code": "39211",
"telephone_number": "601-362-0859",
"fax_number": "601-362-0870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 I-55 N",
"address_2": "SUITE 291, HIGHLAND VILLAGE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392115930",
"telephone_number": "601-362-0859",
"fax_number": "601-362-0870"
}
],
"practiceLocations": [
{
"address_1": "950 E County Line Rd Ste E",
"address_purpose": "LOCATION",
"city": "Ridgeland",
"state": "MS",
"postal_code": "391571928",
"country_code": "US",
"telephone_number": "601-853-9747",
"fax_number": "601-898-4761",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "RACHEL",
"middle_name": "W",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-11",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S3417",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSISSIPPI STATE DEPARTMENT OF HEALTH LICENSE",
"identifier": "S3417",
"state": "MS"
}
],
"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 Jun 22, 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.