Jenica L Taber, MS,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22004455A Issued in IN

Practice address

1111 Ronald Reagan Pkwy
Avon, IN 46123-7085

Phone

(317) 217-3079

Fax

(317) 217-3073

NPI assigned

Jun 12, 2008

Last updated

Jun 12, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jenica L Peters Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1952561946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8440 WANDA LAKE DR",
            "city": "CAMBY",
            "state": "IN",
            "postal_code": "461138718",
            "telephone_number": "317-626-4923",
            "fax_number": "317-217-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 RONALD REAGAN PKWY",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237085",
            "telephone_number": "317-217-3079",
            "fax_number": "317-217-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABER",
        "first_name": "JENICA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004455A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENICA",
            "last_name": "PETERS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Marie Swiezy, RPH
• Rachel Elizabeth Swift, BCBA
• Elizabeth Swords, OD
• Thomas H Swords, OD
• Raven Sykes, LPN
• Rehab Talat, MD
• Serafin M Tandoc, RPT
• Elizabeth Marie Tanner, NP
• Denetra Taylor, M.S., LMHC
• Logan Taylor

• Speech-Language Pathologist in Avon, IN
• Providers in Avon, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.