Individual provider Active NPI

Jo Ann Lavender, MSP

  • Speech-Language Pathologist
  • Columbia, SC
National Provider Identifier
1699130559
Registry record updated Dec 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5859 Issued in SC
Practice address
3001 Beechaven Rd
Columbia, SC 29204-2701
Phone
(803) 782-4363
NPI assigned
Dec 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2015

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 5859 SC Primary

Addresses

Primary practice location

3001 Beechaven Rd
Columbia, SC 29204-2701

Mailing address

811 Forest Park Rd
Columbia, SC 29209-2581
Phone (843) 858-4456

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

LicenseStateTypeSpecialty
5859SCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1450483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450483200000",
    "number": "1699130559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 FOREST PARK RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292092581",
            "telephone_number": "843-858-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BEECHAVEN RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042701",
            "telephone_number": "803-782-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "JO",
        "middle_name": "ANN",
        "credential": "MSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-19",
        "last_updated": "2015-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2015; 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.