Active NPI
Vanessa Kimberly Stevenson
- Speech-Language Pathologist
- Media, PA
National Provider Identifier
1619300696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 24 Veterans SQ
Media, PA 19063-3155 - Phone
- (302) 401-1121
- NPI assigned
- Aug 14, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
24 Veterans SQ
Media, PA 19063-3155
Mailing address
45 N Union Ave Unit 578
Lansdowne, PA 19050-2574
Phone (302) 401-1121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211213001576 | PA | Practitioner - Qualified Speech Language Pathologist | 9032509724 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wall to Wall Speech Therapy LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
651 N Broad St
Ste 205
Middletown, DE 19709
Phone (646) 234-0060
45 N Union Ave
Unit 578
Lansdowne, PA 19050
24 Veterans Sq
Media, PA 19063
Phone (610) 705-7520
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.
-
- Speech-Language Pathologist
- Media, PA
- NPI 1215515168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648252800000",
"number": "1619300696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 N UNION AVE UNIT 578",
"city": "LANSDOWNE",
"state": "PA",
"postal_code": "190502574",
"telephone_number": "302-401-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 VETERANS SQ",
"city": "MEDIA",
"state": "PA",
"postal_code": "190633155",
"telephone_number": "302-401-1121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "VANESSA",
"middle_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-14",
"last_updated": "2022-03-26",
"certification_date": "2022-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.