Jennifer Ann Vidana

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

115946 Issued in TX

Practice address

704 Longmire Rd Ste 101
Conroe, TX 77304-1850

Phone

(936) 441-1525

NPI assigned

Nov 4, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)
• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  NPD (past)

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1164723342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 LONGMIRE RD STE 101",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041850",
            "telephone_number": "936-441-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 LONGMIRE RD STE 101",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041850",
            "telephone_number": "936-441-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDANA",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8816",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP6971",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "115946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary-Lauren Campo Vernon, M.S. CCC-SLP
• Pamela Elizabeth Veronie, NP
• Janzen Viator, AU.D.
• Vibrant Home Care, LLC
• Sarah E Vickers, NP-C
• Hanna Lee Hudson Vierkant
• Gina C Viglietti
• Village Care Homes, LLC
• Village Care Hospice LLC
• Village Green Angels, LLC

• Speech-Language Pathologist in Conroe, TX
• Providers in Conroe, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.