Jerilyn Elissa Agness, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6595 Issued in LA

Practice address

5001 Highway 190 East Service Rd Ste D6
Covington, LA 70433-4956

Phone

(985) 805-2555

Fax

(985) 400-5303

NPI assigned

Mar 11, 2011

Last updated

Mar 22, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Language Learners, LLC

  • Speech-Language Pathologist
  • Lehigh Acres, FL
  • NPI 1528367380
  NPD (past) Authorized official

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1992003107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1609",
            "city": "CHALMETTE",
            "state": "LA",
            "postal_code": "700441609",
            "telephone_number": "985-805-2555",
            "fax_number": "985-400-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HIGHWAY 190 EAST SERVICE RD STE D6",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334956",
            "telephone_number": "985-805-2555",
            "fax_number": "985-400-5303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1544 Canal St",
            "address_purpose": "LOCATION",
            "city": "Lehigh Acres",
            "state": "FL",
            "postal_code": "339365300",
            "country_code": "US",
            "telephone_number": "239-225-3682",
            "fax_number": "239-368-3622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Falconer Dr Ste D-F",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704338210",
            "country_code": "US",
            "telephone_number": "985-805-2555",
            "fax_number": "985-400-5303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGNESS",
        "first_name": "JERILYN",
        "middle_name": "ELISSA",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "6595",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA9847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amita Vyomesh Adhvaryu, MD
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• Aerosol Plus, Inc.
• Amie Aguillard
• Allie Ainsworth
• Shanti Akasapu, MD
• Al IV Enterprises Inc (Kinetics Physical Therapy)
• Crystal Alack, R.N. WHNP

• Speech-Language Pathologist in Covington, LA
• Providers in Covington, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.