Active NPI
Jeni Leeps
- Speech-Language Pathologist
- Jacksonville, FL
National Provider Identifier
1114757499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 21179
- Practice address
- 12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618 - Phone
- (904) 886-3228
- NPI assigned
- Aug 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 21179 | FL | Primary |
Addresses
Primary practice location
12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Mailing address
1815 Dewey PL
Jacksonville, FL 32207-3415
Phone (352) 226-1933
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21179 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1114757499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 DEWEY PL",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322073415",
"telephone_number": "352-226-1933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12276 SAN JOSE BLVD STE 508",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322238618",
"telephone_number": "904-886-3228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEPS",
"first_name": "JENI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-02",
"last_updated": "2024-08-02",
"certification_date": "2024-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "21179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.