Individual provider Active NPI

Jaclyn M Kasperbauer, CCC-SLP

  • Speech-Language Pathologist
  • Scottsdale, AZ
National Provider Identifier
1992109490
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP14272 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone
(480) 301-8000
NPI assigned
Oct 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1796 NE
Speech-Language Pathologist 235Z00000X 444 NE
Speech-Language Pathologist 235Z00000X SLP14272 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5499

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000

Other practice location 1

10820 Wittmus Dr
Papillion, NE 68046-3886
Phone (402) 514-3620

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP14272AZMDSpeech-Language Pathologist
444NEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1992109490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10820 Wittmus Dr",
            "address_purpose": "LOCATION",
            "city": "Papillion",
            "state": "NE",
            "postal_code": "680463886",
            "country_code": "US",
            "telephone_number": "402-514-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASPERBAUER",
        "first_name": "JACLYN",
        "middle_name": "M",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1796",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "444",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP14272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.