Individual provider Active NPI

Carol Sue Jensen, MS, CCC, SLP

  • Speech-Language Pathologist
  • Lincoln, NE
National Provider Identifier
1104903376
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
454 Issued in NE
Practice address
5401 South St
Lincoln, NE 68506-2150
Phone
(402) 483-9587
Fax
(402) 486-9098
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 454 NE Primary

Addresses

Primary practice location

5401 South St
Lincoln, NE 68506-2150

Mailing address

5401 South St
Lincoln, NE 68506-2150
Phone (402) 483-9587

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
454NEMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104903376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-483-9587",
            "fax_number": "402-486-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-483-9587",
            "fax_number": "402-486-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CAROL",
        "middle_name": "SUE",
        "credential": "MS, CCC, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.