Andrew Eliot Jenness, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

08254 Issued in MD

Practice address

201 Booth St
Elkton, MD 21921-5618

Phone

(410) 996-5450

NPI assigned

Dec 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1770055626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 NORTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215611",
            "telephone_number": "410-996-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215618",
            "telephone_number": "410-996-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNESS",
        "first_name": "ANDREW",
        "middle_name": "ELIOT",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "08254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urooj Jaferi, MD
• Jessica Janusz-Grimes, LCSW-C
• Jason Chrystal LLC
• Jeffrey P. Mainolfi,O.D.,Inc.
• Kelly Lynn Jenkins, CRNP-FAMILY
• John Klaus, D.P.M.
• John R. Mulvey M.D., P.a.
• Alison Johnson
• Damien Jamar Johnson Jr.
• Emily Johnson, DPT

• Speech-Language Pathologist in Elkton, MD
• Providers in Elkton, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.

Verify at the official NPI Registry.