Active NPI
Jody Marie Benjamin
- Speech-Language Pathologist
- Bellingham, WA
National Provider Identifier
1639770720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 61090012
- Practice address
- 1112 40TH St
Bellingham, WA 98229-3118 - Phone
- (360) 303-0572
- NPI assigned
- Nov 4, 2020
- 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 | 61090012 | WA | Primary |
Addresses
Primary practice location
1112 40TH St
Bellingham, WA 98229-3118
Mailing address
1112 40TH St
Bellingham, WA 98229-3118
Phone (360) 303-0572
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Bellingham |
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 |
|---|---|---|---|
| 61090012 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1639770720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 40TH ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982293118",
"telephone_number": "360-303-0572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 40TH ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982293118",
"telephone_number": "360-303-0572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "JODY",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "61090012",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Bellingham",
"affiliation": "N",
"address_1": "1112 40th St",
"city": "Bellingham",
"state": "WA",
"country_code": "US",
"postal_code": "982293118",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.