Individual provider Active NPI

Jennifer Lynn Donaldson

  • Speech-Language Pathologist
  • Mesa, AZ
National Provider Identifier
1861925091
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP12290 Issued in AZ
Practice address
7231 E Broadway Rd
Mesa, AZ 85208-2030
Phone
(480) 807-4700
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00862300 NJ
Speech-Language Pathologist 235Z00000X SL013379 PA
Speech-Language Pathologist 235Z00000X SLP12290 AZ Primary

Addresses

Primary practice location

7231 E Broadway Rd
Mesa, AZ 85208-2030

Mailing address

2929 N 70TH St Apt 2019
Scottsdale, AZ 85251-6338
Phone (412) 432-6574

Other practice location 1

1538 Field Club Dr
Pittsburgh, PA 15237-1526
Phone (412) 432-6574

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP12290AZMDSpeech-Language Pathologist
41YS00862300NJMDSpeech-Language Pathologist
SL013379PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1861925091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 N 70TH ST APT 2019",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516338",
            "telephone_number": "412-432-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7231 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082030",
            "telephone_number": "480-807-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1538 Field Club Dr",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152371526",
            "country_code": "US",
            "telephone_number": "412-432-6574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00862300",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL013379",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP12290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.