Abracadabra Speech LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

ABRACADABRA SPEECH LLC

Practice address

6823 Tudor Road
Anchorage, AK 99507

Phone

(907) 317-3727

NPI assigned

Aug 19, 2020

Last updated

Aug 19, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shaaron Donna Jackson, MACCC-SLP

Title

Speech Language Pathologist

Phone

(907) 317-3727

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1710599808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231374",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99523",
            "telephone_number": "907-317-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6823 TUDOR ROAD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99507",
            "telephone_number": "907-317-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRACADABRA SPEECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SHAARON",
        "authorized_official_middle_name": "DONNA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "907-317-3727",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MACCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.