Individual provider Active NPI

Jia Liu, MS, CCC-SLP

  • Speech-Language Pathologist
  • Greensboro, AL
National Provider Identifier
1932224854
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP008215 Issued in GA
Practice address
1502 Main St
Greensboro, AL 36744-1552
Phone
(205) 575-1609
Fax
(334) 624-3960
NPI assigned
Mar 20, 2007
Last updated
Jul 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1729 AL
Speech-Language Pathologist 235Z00000X 2894 MS
Speech-Language Pathologist 235Z00000X SLP008215 GA Primary

Addresses

Primary practice location

1502 Main St
Greensboro, AL 36744-1552

Mailing address

3225 Munsey CT
Cumming, GA 30041-9313
Phone (205) 799-5003

Other identifiers 2

IdentifierTypeStateIssuer
146617MedicaidAL
890016790MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090720000408 AL Practitioner - Qualified Speech Language Pathologist 7113079401 Reassigns benefits to 1 organization
I20201001001001 GA Practitioner - Qualified Speech Language Pathologist 7113079401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1729ALMDSpeech-Language Pathologist
SLP008215GAMDSpeech-Language Pathologist
2894MSMDSpeech-Language Pathologist

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1932224854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 MUNSEY CT",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419313",
            "telephone_number": "205-799-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 MAIN ST",
            "city": "GREENSBORO",
            "state": "AL",
            "postal_code": "367441552",
            "telephone_number": "205-575-1609",
            "fax_number": "334-624-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JIA",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "1729",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "2894",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146617",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890016790",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.