Jennifer Ann Melton, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

200 S Main St
Yazoo City, MS 39194-4010

Phone

(601) 456-0023

Fax

(601) 510-9065

NPI assigned

Oct 8, 2018

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Bold Speech Therapy, LLC

  • Speech-Language Pathologist
  • Yazoo City, MS
  • NPI 1710805791
  NPD (past) Authorized official
• Laskin Therapy Group, P.a.

  • Hearing and Speech Clinic/Center
  • Ridgeland, MS
  • NPI 1629145255

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1841765708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 EOLA DR",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391948203",
            "telephone_number": "601-456-0023",
            "fax_number": "601-510-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391944010",
            "telephone_number": "601-456-0023",
            "fax_number": "601-510-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09057372",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jen@boldspeechtherapy.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "190 Eola Dr",
            "city": "Yazoo City",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391948203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jen@boldspeechtherapy.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "190 Eola Dr",
            "city": "Yazoo City",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391948203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sheila H McKie
• Daniel Calhoun McLeod, DMD
• Mea Primary Care Plus LLC
• Medical Foundation of Central Mississippi (Baptist Medical Clinic)
• Medical Foundation of Central Ms Inc (Baptist PT-Yazoo)
• Michael L Baker DO PA
• Midtown Family Clinic, LLC
• Mississippi CVS Pharmacy LLC (CVS Pharmacy #06396)
• Mississippi State Department of Health
• Amber Moore

• Speech-Language Pathologist in Yazoo City, MS
• Providers in Yazoo City, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.