West Tennessee Cerebral Palsy Association

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

PSS0000000110 Issued in TN

Legal business name

WEST TENNESSEE CEREBRAL PALSY ASSOCIATION

Practice address

34 Garland Dr
Jackson, TN 38305-3654

Phone

(731) 668-3322

Fax

(731) 664-2992

NPI assigned

Aug 30, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy M Prescott

Title

Cfo

Phone

(731) 668-3322

Specialties & licenses 3

Addresses

Other identifiers 4

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1639289077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 GARLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053654",
            "telephone_number": "731-668-3322",
            "fax_number": "731-664-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 GARLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053654",
            "telephone_number": "731-668-3322",
            "fax_number": "731-664-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TENNESSEE CEREBRAL PALSY ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "731-668-3322"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TN",
            "license": "PSS0000000110",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TN",
            "license": "PSS0000000110",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "PSS0000000110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "117255",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TENNESSEE SELECT",
            "identifier": "30997",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "13886",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "446656",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Wendolowski, MD
• Jay M Wentworth, P.T.
• West Tennessee Anesthesia, PC
• West Tennessee Bone and Joint Clinic PC
• West Tennessee Center for Oral and Facial Surgery
• West Tennessee Dentistry PLLC (Dove Family Dentistry)
• West Tennessee ENT Clinic, P.a.
• West Tennessee Eye Associates PC (The Hughes Eye Center)
• West Tennessee Hand Center, PLLC
• West Tennessee Healthcare Anesthesia Associates PLLC

• Speech-Language Pathologist in Jackson, TN
• Providers in Jackson, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.