Active NPI
Jodi Negrin
- Speech-Language Pathologist
- Mercer Island, WA
National Provider Identifier
1720276876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL00003554
- Practice address
- 5704 91St Ave SE
Mercer Island, WA 98040-5033 - Phone
- (206) 852-7774
- NPI assigned
- Oct 12, 2007
- Last updated
- Oct 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | LL00003554 | WA | Primary |
Addresses
Primary practice location
5704 91St Ave SE
Mercer Island, WA 98040-5033
Mailing address
5704 91St Ave SE
Mercer Island, WA 98040-5033
Phone (068) 527-7742
Other practice location 1
2445 140th Ave NE
Suite B-105
Bellevue, WA 98005-1879
Phone (425) 644-6328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LL00003554 | Other | WA | WA STATE LICENSE |
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 |
|---|---|---|---|
| LL00003554 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Children's Therapy PLLC | Speech-Language Pathologist | Current | Accepting new patients |
| Sound Children's Therapy | Speech-Language Pathologist | Past | Accepting new patients |
| Mosaic Rehabilitation, Inc | Past | Accepting new patients | |
| Mosaic Rehabilitation Inc. | Past | Accepting new patients |
Locations
1495 NW Gilman Blvd
Ste 4
Issaquah, WA 98027
Phone (425) 392-2346
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Speech-Language Pathologist
- Mercer Island, WA
- NPI 1184190795
-
- Speech-Language Pathologist
- Greensboro, NC
- NPI 1063348811
-
- Specialist
- Bellevue, WA
- NPI 1972790947
-
- Rehabilitation Clinic/Center
- Bellevue, WA
- NPI 1659595593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539820800000",
"number": "1720276876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5704 91ST AVE SE",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980405033",
"telephone_number": "068-527-7742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5704 91ST AVE SE",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980405033",
"telephone_number": "206-852-7774"
}
],
"practiceLocations": [
{
"address_1": "2445 140th Ave NE",
"address_2": "Suite B-105",
"address_purpose": "LOCATION",
"city": "Bellevue",
"state": "WA",
"postal_code": "980051879",
"country_code": "US",
"telephone_number": "425-644-6328",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NEGRIN",
"first_name": "JODI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-12",
"last_updated": "2018-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL00003554",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA STATE LICENSE",
"identifier": "LL00003554",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.