Individual provider Active NPI

Jessica Lynn Aubin, CCC-SLP

  • Speech-Language Pathologist
  • Bainbridge Island, WA
National Provider Identifier
1790984201
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00004536 Issued in WA
Practice address
330 Madison Ave S Ste 106
Bainbridge Island, WA 98110-2544
Phone
(206) 842-4765
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 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 LL00004536 WA Primary

Addresses

Primary practice location

330 Madison Ave S Ste 106
Bainbridge Island, WA 98110-2544

Mailing address

8285 NE Beck Rd
Bainbridge Island, WA 98110-2234
Phone (206) 842-7443

Other practice location 1

20700 Bond Rd NE Bldg B
Poulsbo, WA 98370-9099
Phone (206) 451-4308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000224 WA Practitioner - Qualified Speech Language Pathologist 4981732336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

330 Madison Ave S
Suite 106
Bainbridge Island, WA 98110-2544
Phone (206) 451-4308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Aubin Aphasia Speech and Language Center LLC CurrentSince Feb 5, 2010 Accepting new patients
Powers Physical Therapy, PLLC PastSince Feb 5, 2010 Accepting new patients

Locations

330 Madison Ave S
Ste 106
Bainbridge Island, WA 98110
Phone (206) 451-4308

20700 Bond Rd NE
Ste 104
Poulsbo, WA 98370
Phone (360) 386-3897

20700 Bond Rd NE
Bldg B
Poulsbo, WA 98370
Phone (206) 451-4308

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1790984201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8285 NE BECK RD",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102234",
            "telephone_number": "206-842-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MADISON AVE S STE 106",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102544",
            "telephone_number": "206-842-4765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20700 Bond Rd NE Bldg B",
            "address_purpose": "LOCATION",
            "city": "Poulsbo",
            "state": "WA",
            "postal_code": "983709099",
            "country_code": "US",
            "telephone_number": "206-451-4308",
            "fax_number": "206-451-4309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUBIN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.