Active NPI
Jennifer Green, MA CCC-SLP
- Speech-Language Pathologist
- Magnolia, AR
National Provider Identifier
1952525974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2327
- Practice address
- 1010 N. Dudney, Suite D
Magnolia, AR 71753 - Phone
- (870) 234-2255
- NPI assigned
- Apr 12, 2007
- Last updated
- Dec 22, 2011
- 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 | 2327 | AR | Primary |
Addresses
Primary practice location
1010 N. Dudney, Suite D
Magnolia, AR 71753
Mailing address
1010 N. Dudney, Suite D
Magnolia, AR 71753
Phone (870) 234-2255
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 161238721 | Medicaid | AR | |
| 12093151 | Other | ASHA |
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)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tooele Clinic Corp | Past | Accepting new patients | |
| Benjamin J Krogh DO PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Grantsville Medical Clinic
- Family Medicine Physician
- Grantsville, UT
- NPI 1972696425
-
- Family Medicine Physician
- Tooele, UT
- NPI 1073512364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1952525974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 N. DUDNEY, SUITE D",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "71753",
"telephone_number": "870-234-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 N. DUDNEY, SUITE D",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "71753",
"telephone_number": "870-234-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "MA CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "2327",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "161238721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA",
"identifier": "12093151",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Magnolia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.