Madelyn Jayne Marie Dorenkamp, SLP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-5886 Issued in ID

Practice address

411 W Haycraft Ave Ste D1
Coeur D Alene, ID 83815-8104

Phone

(208) 664-2468

NPI assigned

Jul 24, 2023

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

Other names 1

• Madelyn Borner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1104506161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13385 N TELLURIDE LOOP",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838353307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W HAYCRAFT AVE STE D1",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158104",
            "telephone_number": "208-664-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORENKAMP",
        "first_name": "MADELYN",
        "middle_name": "JAYNE MARIE",
        "credential": "SLP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-5886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELYN",
            "last_name": "BORNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lucretia M Donahue Reed, LCPC
• Monica F Donegan, PA
• Gianna B Donnelly, PHARMD
• Maura Colleen Donovan, BSW
• Nicole Briana Dooda
• Tara Ashley Dorosh, PA-C
• Kyle Paul Dosch, D.D.S.
• Timothy James Doty, PA
• Philip John Dougherty, MD
• Jeffrey Douglass

• Speech-Language Pathologist in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.