Individual provider Active NPI

Jennifer Walentas Lewon

  • Speech-Language Pathologist
  • Boulder, CO
National Provider Identifier
1104404151
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1258 Issued in CO
Practice address
2501 Kittredge Loop Rd Ucb 409
Boulder, CO 80309-0001
Phone
(303) 492-5375
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1258 CO Primary

Addresses

Primary practice location

2501 Kittredge Loop Rd Ucb 409
Boulder, CO 80309-0001

Mailing address

2501 Kittredge Loop Rd
Boulder, CO 80309-0001
Phone (303) 492-3066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1258COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Colorado Past Accepting new patients
Regents of the University of Colorado PastSince Apr 6, 2021 Accepting new patients
Speech, Language & Hearing Clinic Speech-Language Pathologist PastSince Apr 6, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1104404151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 KITTREDGE LOOP RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090001",
            "telephone_number": "303-492-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KITTREDGE LOOP RD UCB 409",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090001",
            "telephone_number": "303-492-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWON",
        "first_name": "JENNIFER",
        "middle_name": "WALENTAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "1258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.