Individual provider Active NPI

Jessica Jo Wright, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1760714950
Registry record updated Sep 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11899 Issued in NC
Practice address
11201 Livingston Mill Rd
Charlotte, NC 28273-4720
Phone
(704) 654-8599
Fax
(980) 938-6088
NPI assigned
Feb 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2016

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 103435 TX
Speech-Language Pathologist 235Z00000X 11899 NC Primary

Addresses

Primary practice location

11201 Livingston Mill Rd
Charlotte, NC 28273-4720

Mailing address

PO Box 38118
Charlotte, NC 28278-1001
Phone (704) 654-8599

Other names 1

  • Jessica Jo Cantu Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
103435TXMDClinical Social Worker
11899NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Past Accepting new patients
Carolina Concierge Therapeutics, PLLC Speech-Language Pathologist PastSince Oct 30, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474761600000",
    "number": "1760714950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38118",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282781001",
            "telephone_number": "704-654-8599",
            "fax_number": "980-938-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 LIVINGSTON MILL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734720",
            "telephone_number": "704-654-8599",
            "fax_number": "980-938-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JESSICA",
        "middle_name": "JO",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-12",
        "last_updated": "2016-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103435",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CANTU",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2016; 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.