Individual provider Active NPI

Vanessa Kimberly Stevenson

  • Speech-Language Pathologist
  • Media, PA
National Provider Identifier
1619300696
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
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

Updated by the provider on Mar 26, 2022

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 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 IDStateProvider typePAC IDDetails
I20211213001576 PA Practitioner - Qualified Speech Language Pathologist 9032509724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wall to Wall Speech Therapy LLC Speech-Language Pathologist CurrentSince Mar 1, 2022 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.

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.

Verify at the official NPI Registry.