Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1770729998 Individual Practitioner Female Practitioner

Angela Kim Grissom , SLP

Speech-Language Pathologist • Jackson, MS

Professional Overview & Biography Verified Profile Summary

Angela Grissom, SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Jackson, MS. Practice services are available at 733 N. FLAG CHAPEL ROAD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

733 N. Flag Chapel Road

Jackson, MS 39209

Telephone 6019225530
Fax 6019225534
Associated Practice Facility / Clinic
🏢 Magnolia Speech School Facility NPI 1316163389

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Jackson, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.7 Yrs
State Avg: 12.7 Yrs
Regional Practice Density
130 Specialists

Practicing in Jackson, MS (1519 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-09-30
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License MS S2357

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Ms State Board Of Health
S2357 (MS)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Brienne Smith

Audiologist

NPI 1205005071
Carol James , SPEECH, LANGUAGE PATH

Speech-Language Pathologist

NPI 1356539928

SPEECH, LANGUAGEPATH

Lura Ball Beidleman , MS, CFY-SLP

Speech-Language Pathologist

NPI 1487719530

Master of Science, CFYSLP

NPI 1598953168
Renee Haynes

Occupational Therapy Assistant

NPI 1689843450
Brittany Holtmann , MS, CCC-SLP

Speech-Language Pathologist

NPI 1700259447

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
👤
Provider Name / Credentials Updated September 30, 2025

Recorded as ANGELA GRISSOM, SLP

📍
Updated Business Mailing Address February 22, 2023

Registered at 147 PECAN HILL DR, CLINTON, MS 390565233 (Tel: 6018629265)

👤
Provider Name / Credentials Updated February 22, 2023

Recorded as ANGELA TIDWELL, SLP

NPI Profile Active December 17, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location December 17, 2008

Registered at 733 N. FLAG CHAPEL ROAD, JACKSON, MS 39209 (Tel: 6019225530)

📍
Updated Business Mailing Address December 17, 2008

Registered at 733 N. FLAG CHAPEL ROAD, JACKSON, MS 39209 (Tel: 6019225530)

👤
Provider Name / Credentials Updated December 17, 2008

Recorded as KIM HESTLE, SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 17, 2008

Speech-Language Pathologist (License #S2357 in MS)

🟢
Initial NPI Registration & Enumeration December 17, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770729998
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 17, 2008
Last Update: September 30, 2025
Sole Proprietor: Yes

Mailing Address

147 Pecan Hill Dr

Clinton, MS 390565233

Phone: 6018629265

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.