Active NPI
Regina Deanna Jackson Sr., MSP CCC-SLP
- Speech-Language Pathologist
- Columbia, SC
National Provider Identifier
1992958680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4374
- Practice address
- 910 Martha St
Columbia, SC 29203-5032 - Phone
- (803) 206-7690
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 4374 | SC | Primary |
Addresses
Primary practice location
910 Martha St
Columbia, SC 29203-5032
Mailing address
910 Martha St
Columbia, SC 29203-5032
Phone (803) 206-7690
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4374 | SC | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empower to Communicate | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Columbia, SC
- NPI 1194965350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1992958680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 MARTHA ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292035032",
"telephone_number": "803-206-7690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 MARTHA ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292035032",
"telephone_number": "803-206-7690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "REGINA",
"middle_name": "DEANNA",
"name_suffix": "Sr.",
"credential": "MSP CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "4374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.