Individual provider Active NPI

Jenell Anne Zamora, CCC-SLP

  • Speech-Language Pathologist
  • La Grande, OR
National Provider Identifier
1871009704
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12297 Issued in OR
Practice address
610 Sunset Dr
La Grande, OR 97850-1269
Phone
(541) 963-1437
NPI assigned
Dec 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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 12297 OR Primary

Addresses

Primary practice location

610 Sunset Dr
La Grande, OR 97850-1269

Mailing address

62435 Buchanan LN
La Grande, OR 97850-5204

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12297ORMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1871009704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62435 BUCHANAN LN",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978505204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501269",
            "telephone_number": "541-963-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "JENELL",
        "middle_name": "ANNE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "12297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.