Koren Jackson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

013220 Issued in PA

Practice address

7 Highmeadow Rd
Pittsburgh, PA 15215-1423

Phone

(412) 600-9267

NPI assigned

Aug 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Koren Beardshall Former name

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": "1502496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1821513664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HIGHMEADOW RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152151423",
            "telephone_number": "412-600-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HIGHMEADOW RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152151423",
            "telephone_number": "412-600-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KOREN",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-12",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "013220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOREN",
            "last_name": "BEARDSHALL",
            "prefix": "MS.",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joann Jackson, CRNP
• Jonathan Matthew Jackson, DDS
• Kathryn M. Jackson
• Kesha Jackson, LPC
• Kimberly Jackson
• Kyle Lynne Jackson
• Kyle Robert Jackson, PA
• Laura Elizabeth Evans Jackson, MD
• Lindsay Jackson
• Lindsay B Jackson, PA-C

• Speech-Language Pathologist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.