Individual provider Active NPI

Jason Thomas Van Buren

  • Speech-Language Assistant
  • Kansas City, MO
National Provider Identifier
1770119059
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
2023035485 Issued in MO
Practice address
8805 Blue Ridge Blvd
Kansas City, MO 64138-4002
Phone
(346) 431-3454
NPI assigned
Mar 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X 41452 TX
Speech-Language Assistant 2355S0801X 2023035485 MO Primary

Addresses

Primary practice location

8805 Blue Ridge Blvd
Kansas City, MO 64138-4002

Mailing address

8805 Blue Ridge Blvd
Kansas City, MO 64138-4002
Phone (346) 431-3454

Other practice location 1

1606 Norwood St
Deer Park, TX 77536-3718
Phone (281) 670-4333

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
2023035485MOMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1770119059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8805 BLUE RIDGE BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641384002",
            "telephone_number": "346-431-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 BLUE RIDGE BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641384002",
            "telephone_number": "346-431-3454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1606 Norwood St",
            "address_purpose": "LOCATION",
            "city": "Deer Park",
            "state": "TX",
            "postal_code": "775363718",
            "country_code": "US",
            "telephone_number": "281-670-4333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN BUREN",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-18",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "TX",
            "license": "41452",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "MO",
            "license": "2023035485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.