Active NPI
Jennifer Ann Durrua
- Speech-Language Pathologist
- Waterboro, ME
National Provider Identifier
1689434888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP3851
- Practice address
- 86 West Rd
Waterboro, ME 04087-3209 - Phone
- (207) 247-3477
- NPI assigned
- Mar 22, 2024
- 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 | SP3851 | ME | Primary |
Addresses
Primary practice location
86 West Rd
Waterboro, ME 04087-3209
Mailing address
103 Country Way
North Berwick, ME 03906-6181
Phone (732) 547-9182
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 |
|---|---|---|---|
| SP3851 | ME | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711065600000",
"number": "1689434888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 COUNTRY WAY",
"city": "NORTH BERWICK",
"state": "ME",
"postal_code": "039066181",
"telephone_number": "732-547-9182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86 WEST RD",
"city": "WATERBORO",
"state": "ME",
"postal_code": "040873209",
"telephone_number": "207-247-3477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURRUA",
"first_name": "JENNIFER",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-22",
"last_updated": "2024-03-22",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ME",
"license": "SP3851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterboro, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.