Individual provider Active NPI

Jenna Sampson, MA

  • Speech-Language Pathologist
  • Glen Cove, NY
National Provider Identifier
1992219257
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
100 Ridge Dr
Glen Cove, NY 11542-3215
Phone
(516) 801-7310
NPI assigned
Nov 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

100 Ridge Dr
Glen Cove, NY 11542-3215

Mailing address

5 Pine Meadow PL
Commack, NY 11725-1784

Other practice location 1

500 Bi County Blvd Ste 300
Farmingdale, NY 11735-3931
Phone (516) 393-8330

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Speech Language and Swallowing Disorders PLLC Speech-Language Pathologist PastSince Oct 12, 2009 Accepting new patients
South Shore Center for Speech, Language and Swallowing Disorders, LLP Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1511481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1992219257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PINE MEADOW PL",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIDGE DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423215",
            "telephone_number": "516-801-7310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Bi County Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Farmingdale",
            "state": "NY",
            "postal_code": "117353931",
            "country_code": "US",
            "telephone_number": "516-393-8330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "JENNA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-24",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.