Active NPI
Jennifer Ann Lane, M.S., CCC-SLP
- Speech-Language Pathologist
- Ballwin, MO
National Provider Identifier
1245465046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2005020200
- Practice address
- 963 Timber Glen LN
Ballwin, MO 63021-6069 - Phone
- (314) 409-2038
- NPI assigned
- May 22, 2009
- 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 | 2005020200 | MO | Primary |
Addresses
Primary practice location
963 Timber Glen LN
Ballwin, MO 63021-6069
Mailing address
963 Timber Glen LN
Ballwin, MO 63021-6069
Phone (314) 409-2038
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2005020200 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242950400000",
"number": "1245465046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "963 TIMBER GLEN LN",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630216069",
"telephone_number": "314-409-2038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "963 TIMBER GLEN LN",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630216069",
"telephone_number": "314-409-2038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-22",
"last_updated": "2009-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2005020200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.