Individual provider Active NPI

Jenny M Blankenberger, SLP

  • Speech-Language Pathologist
  • Indianapolis, IN
National Provider Identifier
1245589209
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22005499A Issued in IN
Practice address
5916 E Pleasant Run Parkway North Dr
Indianapolis, IN 46219-6005
Phone
(618) 384-6130
NPI assigned
Sep 6, 2012
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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 22005499A IN Primary

Addresses

Primary practice location

5916 E Pleasant Run Parkway North Dr
Indianapolis, IN 46219-6005

Mailing address

5916 E Pleasant Run Parkway North Dr
Indianapolis, IN 46219-6005
Phone (618) 384-6130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122002023 IL Practitioner - Qualified Speech Language Pathologist 6305298761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

1920 Maple Ave
Lisle, IL 60532-2179
Phone (630) 947-2717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22005499AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jan 2, 2024 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jan 2, 2024 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

1112 Oak St
Carmi, IL 62821
Phone (217) 732-9651

1920 Maple Ave
Lisle, IL 60532
Phone (630) 725-7000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1245589209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 E PLEASANT RUN PARKWAY NORTH DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196005",
            "telephone_number": "618-384-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5916 E PLEASANT RUN PARKWAY NORTH DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196005",
            "telephone_number": "618-384-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENBERGER",
        "first_name": "JENNY",
        "middle_name": "M",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005499A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.