Individual provider Active NPI

Jessica Davis, MS CCC-SLP

  • Speech-Language Pathologist
  • Arlington, VA
National Provider Identifier
1629561857
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2203000704 Issued in VA
Practice address
2110 Washington Blvd
Arlington, VA 22204-5719
Phone
(703) 228-4200
NPI assigned
Jun 12, 2018
Last updated
Jun 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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 2203000704 VA Primary

Addresses

Primary practice location

2110 Washington Blvd
Arlington, VA 22204-5719

Mailing address

2110 Washington Blvd
Arlington, VA 22204-5719

Other practice location 1

2700 S Lang St
Arlington, VA 22206-3106
Phone (703) 228-6900

Other practice location 2

3500 23rd St S
Arlington, VA 22206-2461
Phone (703) 228-5825

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2203000704VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1629561857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 WASHINGTON BLVD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 WASHINGTON BLVD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045719",
            "telephone_number": "703-228-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 S Lang St",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222063106",
            "country_code": "US",
            "telephone_number": "703-228-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3500 23rd St S",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222062461",
            "country_code": "US",
            "telephone_number": "703-228-5825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2203000704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.