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JESSICA CLARK
NPI 1770326266
Speech-Language Pathologist in Plymouth, MN

Active since June 13, 2024
15600 36TH AVE N STE 120, PLYMOUTH, MN 55446(763) 595-0812 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jessica Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA CLARK (NPI 1770326266) is an individual speech-language pathologist provider in Plymouth, Minnesota and active in the NPI registry since June 2024. She is a graduate of Other (2023).

NPPES Registry Identity

NPI1770326266
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameJESSICA CLARK
Location Address15600 36TH AVE N STE 120Plymouth, MN 55446-3687
Mailing Address145 Arabian Ave WShakopee, MN 55379-4642 · (925) 864-1720
Phone(763) 595-0812
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateJune 13, 2024
NPPES CertifiedJune 13, 2024
✔ NPI 1770326266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
15600 36TH AVE N STE 120, Plymouth, MN 55446
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4486194719
PECOS Enrollment IDI20260821001673

Medicare Billing Reassignments

2

Medicare enrollment records show Jessica Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Expressable Therapy PC
1,038 mi
Speech-Language Pathologist
7600 CHEVY CHASE DR, BLDG 2 SUITE 300
Austin, TX 78752
  • Reassigned Medicare billing, Minnesota enrollment
  • 6 clinicians in this Medicare group
NPI 1134875370 (512) 377-6318
Expressable Speech-Language Pathology, P.C.
1,041 mi
Speech-Language Pathologist
3800 N LAMAR BLVD STE 200
Austin, TX 78756
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Expressable Speech-Language Pathology PC
  • 179 clinicians in this Medicare group
NPI 1649875857 (512) 377-6318

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN STUMPF
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
LINDSAY RENEE BARRETT MA/CCC-SLP
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
ELIZABETH ELAINE MCGLYNN
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
SARAH JOY MOEN PT, DPT
Physical Therapist (Pediatrics)
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
ELIZABETH ASTURIAS MS OTR/L
Occupational Therapist (Pediatrics)
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
KAYE M BAUMGARDNER MS CCC-SLP, COM, CLC
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
BRITTANY WINTER
Occupational Therapist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
KATHERINE ELIZABETH LAMB MS CCC-SLP
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (635) 950-8127

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Clark's NPI number?

The NPI number for Jessica Clark is 1770326266. It was assigned to this individual provider in the NPPES registry on June 13, 2024.

Where is Jessica Clark located?

Jessica Clark practices at 15600 36th Ave N Ste 120, Plymouth, MN 55446. The listed phone number is (763) 595-0812.

What is Jessica Clark's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Jessica Clark enrolled in Medicare?

Yes. Jessica Clark is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jessica Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Clark reassigns Medicare benefits to 2 organizations: Expressable Therapy PC (Austin, TX) and Expressable Speech-Language Pathology, P.C. (Austin, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jessica Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jessica Clark was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.