Jessica M Clement

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.013237 Issued in IL

Practice address

125 S Webster Ave
Jacksonville, IL 62650

Phone

(217) 479-6312

NPI assigned

Jun 18, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Supplemental Health Care

  • Adult Care Home Facility
  • Saint Louis, MO
  • NPI 1902129653
  NPD (past)

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1972033363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S WEBSTER AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501877",
            "telephone_number": "217-479-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S WEBSTER AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62650",
            "telephone_number": "217-479-6312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11960 Westline Industrial Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631463209",
            "country_code": "US",
            "telephone_number": "866-433-9555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "JESSICA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2016029414",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.013237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandupatla Probhakar MD
• Richard E Charpentier II, D.C.
• Chiropractic Healthcare PC
• Christina J. Levi O D P C
• Mickie Clark, COTA
• Kristine Ann Cockerill, R.PH.
• Beaux Cole, PHARM. D.
• Carrie S Cole, RN
• Jonathan Daniel Colen, DO
• Michelle Colen, M.D.

• Speech-Language Pathologist in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.