Individual provider Active NPI

Jenna Dalgarn, SLP

  • Speech-Language Pathologist
  • State College, PA
National Provider Identifier
1609340918
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL014915 Issued in PA
Practice address
500 E Marylyn Ave
State College, PA 16801-6269
Phone
(814) 238-3322
NPI assigned
Jan 20, 2019
Last updated
Oct 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 SA16871 FL
Speech-Language Pathologist 235Z00000X SL014915 PA Primary

Addresses

Primary practice location

500 E Marylyn Ave
State College, PA 16801-6269

Mailing address

500 E Marylyn Ave
State College, PA 16801-6269
Phone (814) 207-7172

Other practice location 1

1504 Seabreeze Ave
Jacksonville Beach, FL 32250-3365
Phone (904) 249-7421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250324001930 SC Practitioner - Qualified Speech Language Pathologist 3678095221 Reassigns benefits to 1 organization
I20250416003879 NC Practitioner - Qualified Speech Language Pathologist 3678095221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

1402 Hospital Plaza Dr
Wilmington, NC 28401-6659
Phone (910) 762-1130

2910 Pine Plantation Pkwy
Oak Island, NC 28461-0119
Phone (910) 444-2940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8765SCMDPhysical Therapist
SA16871FLMDSpeech-Language Pathologist
SL014915PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Mar 31, 2025 Accepting new patients
Legacy Healthcare Services, Inc. Speech-Language Pathologist CurrentSince Mar 31, 2025 Accepting new patients
The Weston Group of South Carolina Inc Speech-Language Pathologist CurrentSince Feb 24, 2025 Accepting new patients

Locations

2701 Pickett Rd
Durham, NC 27705
Phone (919) 419-4012

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

Organizations & group practices 4

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": "1547942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1609340918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E MARYLYN AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016269",
            "telephone_number": "814-207-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MARYLYN AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016269",
            "telephone_number": "814-238-3322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1504 Seabreeze Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322503365",
            "country_code": "US",
            "telephone_number": "904-249-7421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALGARN",
        "first_name": "JENNA",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-20",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA16871",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL014915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.