Jessica Bauer, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

28636 Issued in CA

Practice address

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321

Phone

(888) 265-2680

NPI assigned

Aug 26, 2014

Last updated

Jun 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Red Door Pediatric Therapy, Inc

  dba Red Door Pediatric Therapy

  • Speech-Language Pathologist
  • Bismarck, ND
  • NPI 1639257033
  NPD (past)

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1639579766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030574",
            "telephone_number": "701-222-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288321",
            "telephone_number": "888-265-2680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2625 N 19th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585030574",
            "country_code": "US",
            "telephone_number": "701-222-3175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "JESSICA",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1370",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "SLP-SP-LIC-5948",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "28636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1370",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Barton
• Luke Basdeo, MD
• Meghan Bastenbeck
• Christina Marie Bates, L.M.T.
• Joseph Battaglia, DC
• Hommy Bayron Rivera, DC
• Beacon Chiro and Wellness PLLC (Beacon Chiropractic and Wellness)
• Molly Bear
• Kathleen Beatty
• Marielle Youmans Beauchamp, DMD

• Speech-Language Pathologist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.