Evonna Louise Leyendekker, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

103998 Issued in TX

Practice address

1600 Texas St
Fort Worth, TX 76102-3497

Phone

(817) 338-2400

NPI assigned

Sep 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehab Specialists Outpatient LLCGroup PAC ID 6507254497, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Rehab Specialists Outpatient, LLC

  • Clinic/Center
  • Milwaukie, OR
  • NPI 1679240824

  Speech-Language Pathologist, TX

  Medicare reassignment Care Compare group NPD
• Rehab Specialists Outpatient, LLC

  • Clinic/Center
  • Canby, OR
  • NPI 1437019015

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1093487829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 CRATER LAKE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374449",
            "telephone_number": "817-736-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 TEXAS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023497",
            "telephone_number": "817-338-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYENDEKKER",
        "first_name": "EVONNA",
        "middle_name": "LOUISE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elleyendekker@consonushealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1600 Texas St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761023497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vincent Jerome Lewis, D.O.
• Sherry Lexington, FNP-C
• Renee Marie Lexow, PSYD
• Tiffany Andresen Ley
• Abigail Leyba
• Brianda Valeria Leza, CPNP
• LHCG Xxxiii, LLC
• Guiyuan Li, M.D./PH.D
• Huiling Li
• Lucy Luxi Li, MD

• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.