Individual provider Active NPI

Carol Maddox Jaworski, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Avon Lake, OH
National Provider Identifier
1700018736
Registry record updated Aug 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP5800 Issued in OH
Practice address
602 Tournament Dr
Avon Lake, OH 44012-2284
Phone
(440) 221-0444
NPI assigned
Aug 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2009

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 SP5800 OH Primary

Addresses

Primary practice location

602 Tournament Dr
Avon Lake, OH 44012-2284

Mailing address

27965 Southbridge Cir
Westlake, OH 44145-5323
Phone (440) 871-5071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091221000442 OH Practitioner - Qualified Speech Language Pathologist 0648310797 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Oh, LLC Speech-Language Pathologist CurrentSince Jan 1, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Oct 1, 2019 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Oct 1, 2019 Accepting new patients
Vox Solutions, LLC Past Accepting new patients
Just in Time Therapy, Inc Speech-Language Pathologist Past Accepting new patients

Locations

6525 N High St
Worthington, OH 43085
Phone (332) 230-2813

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": "1249776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249776000000",
    "number": "1700018736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27965 SOUTHBRIDGE CIR",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455323",
            "telephone_number": "440-871-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 TOURNAMENT DR",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122284",
            "telephone_number": "440-221-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWORSKI",
        "first_name": "CAROL",
        "middle_name": "MADDOX",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-09",
        "last_updated": "2009-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP5800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2009; 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.