Individual provider Active NPI

Jessica Forrester Groce, SLP/CCC

  • Speech-Language Pathologist
  • Chattanooga, TN
National Provider Identifier
1750010179
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9750 Issued in GA
Practice address
4071 S Access Rd Ste 108
Chattanooga, TN 37406-1200
Phone
(423) 894-4774
Fax
(423) 894-4775
NPI assigned
Jun 9, 2022
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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 9750 GA Primary

Addresses

Primary practice location

4071 S Access Rd Ste 108
Chattanooga, TN 37406-1200

Mailing address

PO Box 903
Hixson, TN 37343-0903
Phone (423) 894-4774

Other identifiers 1

IdentifierTypeStateIssuer
SLP009750OtherGASPEECH-LANGUAGE PATHOLOGIST 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

LicenseStateTypeSpecialty
9750GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics Plus, Inc. Speech-Language Pathologist PastSince Jun 12, 2022 Accepting new patients

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": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1750010179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 903",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373430903",
            "telephone_number": "423-894-4774",
            "fax_number": "423-894-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 S ACCESS RD STE 108",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374061200",
            "telephone_number": "423-894-4774",
            "fax_number": "423-894-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCE",
        "first_name": "JESSICA",
        "middle_name": "FORRESTER",
        "name_prefix": "Mrs.",
        "credential": "SLP/CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "9750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGIST STATE LICENSE",
            "identifier": "SLP009750",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.