Individual provider Active NPI

Jennifer Vazirian, CCC SLP

  • Speech-Language Pathologist
  • San Antonio, TX
National Provider Identifier
1730583774
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109362 Issued in TX
Practice address
8519 Ridge Stone St
San Antonio, TX 78251-2203
Phone
(210) 779-3592
Fax
(210) 520-0464
NPI assigned
Oct 20, 2014
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0188501 NY
Speech-Language Pathologist 235Z00000X 109362 TX Primary

Addresses

Primary practice location

8519 Ridge Stone St
San Antonio, TX 78251-2203

Mailing address

8403 State Highway 151 Ste 104
San Antonio, TX 78245-2055
Phone (210) 779-3592

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

LicenseStateTypeSpecialty
109362TXMDClinical Social Worker
0188501NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Circles LLC Speech-Language Pathologist CurrentSince Oct 8, 2023 Accepting new patients

Locations

8403 State Highway 151
Ste 104
San Antonio, TX 78245
Phone (210) 714-5507

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1730583774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8403 STATE HIGHWAY 151 STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782452055",
            "telephone_number": "210-779-3592",
            "fax_number": "210-520-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8519 RIDGE STONE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782512203",
            "telephone_number": "210-779-3592",
            "fax_number": "210-520-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZIRIAN",
        "first_name": "JENNIFER",
        "credential": "CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0188501",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.