Active NPI
Melissa Michelle Jackson, M.A., CCC-SLP
- Speech-Language Pathologist
- Ruston, LA
National Provider Identifier
1992048482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6800
- Practice address
- 707 Marie Ave
Ruston, LA 71270-2715 - Phone
- (985) 209-1827
- NPI assigned
- Apr 3, 2013
- 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 | 6800 | LA | Primary |
Addresses
Primary practice location
707 Marie Ave
Ruston, LA 71270-2715
Mailing address
707 Marie Ave
Ruston, LA 71270-2715
Phone (985) 209-1827
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6800 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1992048482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 MARIE AVE",
"city": "RUSTON",
"state": "LA",
"postal_code": "712702715",
"telephone_number": "985-209-1827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 MARIE AVE",
"city": "RUSTON",
"state": "LA",
"postal_code": "712702715",
"telephone_number": "985-209-1827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MELISSA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-03",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "6800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.