Active NPI
Jennifer Burgess, CCC-SLP
- Speech-Language Pathologist
- Valdese, NC
National Provider Identifier
1902259963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1703068
- Practice address
- 127 Main Street West
Valdese, NC 28690 - Phone
- (282) 368-0729
- Fax
- (828) 368-0688
- NPI assigned
- Jul 14, 2016
- Last updated
- Apr 25, 2017
- Sex
- Female
- 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 Pathologist | 235Z00000X | 1703068 | NC | Primary |
Addresses
Primary practice location
127 Main Street West
Valdese, NC 28690
Mailing address
229 Taylor Cir
Granite Falls, NC 28630-9366
Phone (828) 334-6800
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 |
|---|---|---|---|
| 1703068 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1902259963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 TAYLOR CIR",
"city": "GRANITE FALLS",
"state": "NC",
"postal_code": "286309366",
"telephone_number": "828-334-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 MAIN STREET WEST",
"city": "VALDESE",
"state": "NC",
"postal_code": "28690",
"telephone_number": "282-368-0729",
"fax_number": "828-368-0688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "JENNIFER",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-14",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "1703068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valdese, NC
- Blue Ridge Healthcare Medical Group, Inc. (AFFINITY Face and Body Center)
- Blue Ridge Healthcare Medical Group, Inc. (Drexel Medical Practice)
- Blueridge Healthcare Surgery Center, LLC
- Joe Wilson Bradshaw, PTA
- Nicole Maria Brown, LPTA
- Burke Hospice and Palliative Care, Inc.
- Harold Keith Cantrell, LPC
- Carolinas Medical Center at Home, LLC (Healthy @ Home - Blue Ridge HealthCare Lifeline)
- Cassie Brown Counseling
- Chimiak Medical Solutions, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.