Active NPI
Jeffrey David Tavares, SLPA
- Speech-Language Assistant
- Fall River, MA
National Provider Identifier
1891074670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SP-489-SA
- Practice address
- 1575 N Main St
Fall River, MA 02720-2917 - Phone
- (508) 324-1060
- NPI assigned
- Aug 10, 2011
- Last updated
- Aug 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SP-489-SA | MA | Primary |
Addresses
Primary practice location
1575 N Main St
Fall River, MA 02720-2917
Mailing address
1575 N Main St
Fall River, MA 02720-2917
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP-489-SA | MA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312934400000",
"number": "1891074670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 N MAIN ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027202917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 N MAIN ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027202917",
"telephone_number": "508-324-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAVARES",
"first_name": "JEFFREY",
"middle_name": "DAVID",
"credential": "SLPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-10",
"last_updated": "2011-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "MA",
"license": "SP-489-SA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.