Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1881059624 Individual Practitioner Female Practitioner

Jill Bain Wine , MA, CCC-SLP

Speech-Language Pathologist • King George, VA

Professional Overview & Biography Verified Profile Summary

Jill Wine, MA, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in King George, VA. Practice services are available at 5254 POTOMAC DR STE A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5254 Potomac Dr Ste A

King George, VA 22485

Telephone 5408503940
Fax 5715509758
Associated Practice Facility / Clinic
🏢 Jp Frye Llc Facility NPI 1558132449

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in King George, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.2 Yrs
Regional Practice Density
11 Specialists

Practicing in King George, VA (4974 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

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License VA 2202007993

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.

Secondary Practice Locations

2765 Jefferson Davis Hwy, Ste. 203

Stafford, VA 225548331

Phone: 5407202261

Practice Associates & Co-Workers

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

5 Associated Practitioners
James Frye , PERSONAL TRAINER

Day Training/Habilitation Specialist

NPI 1023888674

PERSONALTRAINER

Dr. Abby Hammack , DPT

Physical Therapist

NPI 1184900565

Doctor of Physical Therapy

NPI 1275151201

Doctor of Physical Therapy

Annie Cardwell , PT

Physical Therapist

NPI 1295032316

Physical Therapist

Sean Lipson , LPTA

Physical Therapy Assistant

NPI 1972103091

Licensed Physical Therapist Assistant

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location July 14, 2018

Registered at 5254 POTOMAC DR STE A, KING GEORGE, VA 22485 (Tel: 5408503940)

📍
Updated Business Mailing Address July 14, 2018

Registered at 7072 KITCHEN DR, KING GEORGE, VA 224855225 (Tel: 5408503940)

NPI Profile Active December 21, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location December 21, 2015

Registered at 2765 JEFFERSON DAVIS HWY, STE. 203, STAFFORD, VA 225548331 (Tel: 5407202261)

📍
Updated Business Mailing Address December 21, 2015

Registered at 2765 JEFFERSON DAVIS HWY, STE. 203, STAFFORD, VA 225548331 (Tel: 5407202261)

👤
Provider Name / Credentials Updated December 21, 2015

Recorded as JILL WINE, M.A., CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 21, 2015

Speech-Language Pathologist (License #2202007993 in VA)

🟢
Initial NPI Registration & Enumeration December 21, 2015

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: 1881059624
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 21, 2015
Last Update: July 14, 2018
Sole Proprietor: Yes

Mailing Address

7072 Kitchen Dr

King George, VA 224855225

Phone: 5408503940

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.