Individual provider Active NPI

Cheryl Lynn Juracek, SLP

  • Speech-Language Pathologist
  • Tyndall, SD
National Provider Identifier
1245783547
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
312-LIMITED Issued in SD
Practice address
406 W 14TH Ave
Tyndall, SD 57066-2280
Phone
(605) 589-3134
NPI assigned
Aug 3, 2016
Last updated
Aug 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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 312-LIMITED SD Primary

Addresses

Primary practice location

406 W 14TH Ave
Tyndall, SD 57066-2280

Mailing address

406 W 14TH Ave
Tyndall, SD 57066-2280
Phone (605) 589-3134

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

LicenseStateTypeSpecialty
312-LIMITEDSDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1245783547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W 14TH AVE",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "570662280",
            "telephone_number": "605-589-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W 14TH AVE",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "570662280",
            "telephone_number": "605-589-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURACEK",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SD",
            "license": "312-LIMITED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyndall, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.