Bethany Marie Jacobs, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.15254 Issued in OH

Practice address

38957 Detroit Rd
Avon, OH 44011-2160

Phone

(330) 224-4886

NPI assigned

May 29, 2023

Last updated

May 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685318400000",
    "number": "1801589718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38957 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38957 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112160",
            "telephone_number": "330-224-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BETHANY",
        "middle_name": "MARIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-29",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.15254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Renee Illius, BCBA
• Esme Susanne Irvine, DO
• Wahib E Isac, MD
• Erin Nicole Isenberg
• Jacobs Eye Center, LTD. (Anne Jacobs MD LLC)
• Katherine Anne Jacobs, M.D.
• Joyce Garcia Jacquet, CRNA
• Rashmi Jain, M.D
• David R Jake
• Mohammed A Jayber, DO

• Speech-Language Pathologist in Avon, OH
• Providers in Avon, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; 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.