Jennifer Lynn Stark, M.A. CCC-SLP, CBIS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

32715 Grand River Ave
Farmington, MI 48336-3113

Phone

(248) 427-1310

NPI assigned

Feb 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Nrmi, LLC

  • Rehabilitation Clinic/Center
  • Livonia, MI
  • NPI 1760129365

  Single Specialty

  NPD

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1316448228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8988 TAVISTOCK CT",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32715 GRAND RIVER AVE",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483363113",
            "telephone_number": "248-427-1310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28511 Orchard Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483342933",
            "country_code": "US",
            "telephone_number": "248-306-3170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "M.A. CCC-SLP, CBIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Farmington, MI
• Providers in Farmington, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.