Jenna Rode, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Spencerville, IN
NPI 1114495199 · NPPES record last updated Nov 7, 2018
Key facts
- NPI
- 1114495199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 18923 Lochner Rd
Spencerville, IN 46788-9609 - Phone
- (260) 437-7782
- NPI assigned
- Nov 7, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- My Wellness Team LLC
Practice addresses (Care Compare)
4411 Park Place Dr
Fort Wayne, IN 46845-8607
Phone (866) 360-9355
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122002687 | IN | Practitioner - Qualified Speech Language Pathologist | 9234581620 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Wellness Team LLC | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
4411 Park Place Dr
Fort Wayne, IN 46845
Phone (260) 205-8451
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | IN | Yes |
Addresses
Primary practice location
18923 Lochner Rd
Spencerville, IN 46788-9609
Mailing address
18923 Lochner Rd
Spencerville, IN 46788-9609
Phone (260) 437-7782
Other providers in Spencerville, IN
All providers in Spencerville, IN · Speech-Language Pathologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.