Individual provider Active NPI

Jennifer Rae Lovejoy

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1043756455
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2290 Issued in ND
Practice address
3120 25TH St S Ste N
Fargo, ND 58103-6110
Phone
(701) 205-4194
Fax
(701) 540-9044
NPI assigned
Jan 9, 2017
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 112114 TX
Speech-Language Pathologist 235Z00000X 2290 ND Primary

Addresses

Primary practice location

3120 25TH St S Ste N
Fargo, ND 58103-6110

Mailing address

3120 25TH St S Ste N
Fargo, ND 58103-6110
Phone (701) 205-4194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514001084 ND Practitioner - Qualified Speech Language Pathologist 6406297068 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2290NDMDSpeech-Language Pathologist
112114TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Kids Therapy, LTD. Speech-Language Pathologist CurrentSince Feb 18, 2024 Accepting new patients
Great Kids Therapy, LTD CurrentSince Apr 7, 2024 Accepting new patients
Greater Learning, LP Speech-Language Pathologist PastSince Feb 17, 2016 Accepting new patients
Grow Strong Together Speech-Language Pathologist Past Accepting new patients

Locations

3120 25th St S
Ste N
Fargo, ND 58103
Phone (701) 205-4194

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1043756455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 25TH ST S STE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036110",
            "telephone_number": "701-205-4194",
            "fax_number": "701-540-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 25TH ST S STE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036110",
            "telephone_number": "701-205-4194",
            "fax_number": "701-540-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVEJOY",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "112114",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.