Active NPI
Rebecca Black
- Speech-Language Pathologist
- Jasper, AL
National Provider Identifier
1629134895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 935
- Practice address
- 4330 Highway 78 E
Suite 118
Jasper, AL 35501-8905 - Phone
- (866) 537-5613
- NPI assigned
- Dec 29, 2006
- 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 | 935 | AL | Primary |
Addresses
Primary practice location
4330 Highway 78 E
Suite 118
Jasper, AL 35501-8905
Mailing address
484 Valley School Rd
Jasper, AL 35504-6437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 935 | Other | AL | SPEECH THERAPY 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 935 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629134895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "484 VALLEY SCHOOL RD",
"city": "JASPER",
"state": "AL",
"postal_code": "355046437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4330 HIGHWAY 78 E",
"address_2": "SUITE 118",
"city": "JASPER",
"state": "AL",
"postal_code": "355018905",
"telephone_number": "866-537-5613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "REBECCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "935",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH THERAPY LICENSE",
"identifier": "935",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jasper, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.