Active NPI
Jazlyn Sharissa Wiggins, CCC-SLP
- Speech-Language Pathologist
- Houston, TX
National Provider Identifier
1679266704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8062
- Practice address
- 2100 Shadowdale Dr
Houston, TX 77043-2608 - Phone
- (252) 265-2561
- NPI assigned
- Jun 2, 2023
- 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 | 8062 | SC | Primary |
Addresses
Primary practice location
2100 Shadowdale Dr
Houston, TX 77043-2608
Mailing address
1711 Caroline St Apt 627
Houston, TX 77002-3355
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8062 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1679266704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 CAROLINE ST APT 627",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770023355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 SHADOWDALE DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770432608",
"telephone_number": "252-265-2561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "JAZLYN",
"middle_name": "SHARISSA",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-02",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "8062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.