Individual provider Active NPI

Jazzmin Zama

  • Speech-Language Pathologist
  • Rio Rancho, NM
National Provider Identifier
1679030696
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
CF7411 Issued in NM
Practice address
661 Quantum Rd NE Ste 1
Rio Rancho, NM 87124-4505
Phone
(505) 554-0052
NPI assigned
Feb 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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 CF7411 NM Primary

Addresses

Primary practice location

661 Quantum Rd NE Ste 1
Rio Rancho, NM 87124-4505

Mailing address

661 Quantum Rd NE Ste 1
Rio Rancho, NM 87124-4505
Phone (505) 554-0052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240917003707 IL Practitioner - Qualified Speech Language Pathologist 8527509694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CF7411NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bosque Therapy Center, LLC Speech-Language Pathologist CurrentSince Mar 6, 2022 Accepting new patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Aug 5, 2024 Accepting new patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Aug 5, 2024 Accepting new patients
Jumpstart, LLC PastSince Aug 25, 2024 Accepting new patients
Jumpstart, LLC Speech-Language Pathologist PastSince Apr 1, 2021 Accepting new patients

Locations

550 Kildeer Dr
Bolingbrook, IL 60440
Phone (630) 634-5044

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

661 Quantum Rd NE
Ste 1
Rio Rancho, NM 87124
Phone (505) 554-0052

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1679030696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 QUANTUM RD NE STE 1",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244505",
            "telephone_number": "505-554-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 QUANTUM RD NE STE 1",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244505",
            "telephone_number": "505-554-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMA",
        "first_name": "JAZZMIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "CF7411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.