NPIMap

Individual provider Active NPI

Jennifer L Pedri, SLP

  • Speech-Language Pathologist
  • Charlottesville, VA
National Provider Identifier
1609189026
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202008418 Issued in VA
Practice address
3010 Berkmar Dr
Charlottesville, VA 22901-1443
Phone
(434) 973-5031
Fax
(434) 973-0520
NPI assigned
Jul 15, 2010
Last updated
May 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 4691 SC
Speech-Language Pathologist 235Z00000X 2202008418 VA Primary

Addresses

Primary practice location

3010 Berkmar Dr
Charlottesville, VA 22901-1443

Mailing address

1946 Lonicera Way
Charlottesville, VA 22911-9031
Phone (843) 655-6345

Other practice location 1

8703 Highway 17 Byp S
Ste I
Myrtle Beach, SC 29575-7701
Phone (843) 457-1053

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
2202008418VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Young Talkers, LLC Speech-Language Pathologist Past Accepting new patients
Young Talkers, LLC Speech-Language Pathologist PastSince Oct 28, 2011 Accepting new patients
Blue Ridge Rehabilitation Associates, Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1609189026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 LONICERA WAY",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229119031",
            "telephone_number": "843-655-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 BERKMAR DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011443",
            "telephone_number": "434-973-5031",
            "fax_number": "434-973-0520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8703 Highway 17 Byp S",
            "address_2": "Ste I",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295757701",
            "country_code": "US",
            "telephone_number": "843-457-1053",
            "fax_number": "843-215-2910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDRI",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4691",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.