Jacquline Marie Ely

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2204000300 Issued in VA

Practice address

625 Piney Forest Rd Ste 407
Danville, VA 24540-2870

Phone

(434) 799-7732

NPI assigned

Jan 14, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1629618947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 PINEY FOREST RD STE 407",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402870",
            "telephone_number": "434-799-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PINEY FOREST RD STE 407",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402870",
            "telephone_number": "434-799-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "JACQULINE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204000300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elkington, OTR, CNT, CIMI
• Dianne Elizabeth Elliott, FNP
• Tracey Ellis, B.S.,QMHP-C
• Mostafa Gamal Hussien Ab Elrazzaz
• Ehab Elsayed, PHD
• Richard P Embrey, M.D.
• Emeritus Corp.
• Emotional Expressions, LLC
• Jason L Ensminger, M.D.
• Envisioned Behavioral Health Services, LLC

• Speech-Language Pathologist in Danville, VA
• Providers in Danville, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.