Individual provider Active NPI

Jessica Nicole Bernardo, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Estero, FL
National Provider Identifier
1952853020
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA20028 Issued in FL
Practice address
9470 Corkscrew Palms Cir Ste 104
Estero, FL 33928-3305
Phone
(239) 400-1705
NPI assigned
Oct 25, 2016
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X TL-2750 NJ
Speech-Language Pathologist 235Z00000X SA20028 FL Primary

Addresses

Primary practice location

9470 Corkscrew Palms Cir Ste 104
Estero, FL 33928-3305

Mailing address

5240 SW 3Rd Ave
Cape Coral, FL 33914-7120
Phone (732) 829-2144

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA20028FLMDSpeech-Language Pathologist
TL-2750NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1952853020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 SW 3RD AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339147120",
            "telephone_number": "732-829-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470 CORKSCREW PALMS CIR STE 104",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283305",
            "telephone_number": "239-400-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDO",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "TL-2750",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.