Individual provider Active NPI

Jessica Anderson

  • Speech-Language Pathologist
  • Ann Arbor, MI
National Provider Identifier
1699688366
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101003031 Issued in MI
Practice address
1819 S Wagner Rd
Ann Arbor, MI 48103-9715
Phone
(734) 629-7363
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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 7101003031 MI Primary

Addresses

Primary practice location

1819 S Wagner Rd
Ann Arbor, MI 48103-9715

Mailing address

4779 Five Mile Rd
Ann Arbor, MI 48105-9421
Phone (734) 629-7363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1699688366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4779 FIVE MILE RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059421",
            "telephone_number": "734-629-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 S WAGNER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039715",
            "telephone_number": "734-629-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101003031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.