Active NPI
Jennifer Marie Tong, CCC/SLP
- Speech-Language Pathologist
- Maynardville, TN
National Provider Identifier
1902581853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4020
- Practice address
- 215 Richardson Way
Maynardville, TN 37807-3803 - Phone
- (865) 992-5816
- NPI assigned
- Jun 19, 2023
- 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 | 4020 | TN | Primary |
Addresses
Primary practice location
215 Richardson Way
Maynardville, TN 37807-3803
Mailing address
156 Morgan Memorial Rd
Rose Hill, VA 24281-8514
Phone (606) 670-1544
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 |
|---|---|---|---|
| 4020 | TN | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687132800000",
"number": "1902581853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 MORGAN MEMORIAL RD",
"city": "ROSE HILL",
"state": "VA",
"postal_code": "242818514",
"telephone_number": "606-670-1544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 RICHARDSON WAY",
"city": "MAYNARDVILLE",
"state": "TN",
"postal_code": "378073803",
"telephone_number": "865-992-5816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONG",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-19",
"last_updated": "2023-06-19",
"certification_date": "2023-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "4020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maynardville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.