Individual provider Active NPI

Jeidy Marmol

  • Speech-Language Pathologist
  • Manassas, VA
National Provider Identifier
1720995509
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2204001838 Issued in VA
Practice address
14715 Bristow Rd
Manassas, VA 20112-3945
Phone
(703) 791-8845
NPI assigned
Aug 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 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 2204001838 VA Primary

Addresses

Primary practice location

14715 Bristow Rd
Manassas, VA 20112-3945

Mailing address

3105 Clover LN
Culpeper, VA 22701-3988

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": "1787702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1720995509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 CLOVER LN",
            "city": "CULPEPER",
            "state": "VA",
            "postal_code": "227013988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14715 BRISTOW RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123945",
            "telephone_number": "703-791-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOL",
        "first_name": "JEIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204001838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.