Jessica Pangborn, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2011013608 Issued in MO

Practice address

2011 Corona Rd Ste 301
Columbia, MO 65203-2548

Phone

(314) 543-3860

NPI assigned

Jun 6, 2012

Last updated

Jun 6, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reliant Care Rehabilitative Services L L C

  • Physical Therapy Clinic/Center
  • Columbia, MO
  • NPI 1902188287
  NPD (past)
• Kelly Mingus Speech Pathology LLC

  dba Dream Big Pediatric Therapies

  • Hearing and Speech Clinic/Center
  • Franklin, TN
  • NPI 1215409776
  NPD (past)

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1922369909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15444 S GREENWOOD ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660623460",
            "telephone_number": "414-405-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 CORONA RD STE 301",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032548",
            "telephone_number": "314-543-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGBORN",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2011013608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela S Gulley, MD, LLC
• Bogdan Alexandru Panaitescu, MD
• Srinivas Krishna Chaitanya Panchangam, M.D.
• Paul Edward Pancoast, ME
• Abinash Pandey, MD
• Rachel Dawn Pangburn, MSW, LCSW
• Theppharit Panichsillapakit, MD
• Cedric Papa, D.D.S.
• Shafaq Paracha, MD
• John A Pardalos, M.D.

• Speech-Language Pathologist in Columbia, MO
• Providers in Columbia, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.