Active NPI
Kendall Renee Sermerseim
- Speech-Language Pathologist
- Jasper, IN
National Provider Identifier
1326752346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22007407A
- Practice address
- 2515 Newton St
Jasper, IN 47546-1329 - Phone
- (812) 482-1722
- NPI assigned
- Jan 13, 2023
- 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 | 22007407A | IN | Primary |
Addresses
Primary practice location
2515 Newton St
Jasper, IN 47546-1329
Mailing address
2515 Newton St
Jasper, IN 47546-1329
Phone (812) 482-1722
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22007407A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673568000000",
"number": "1326752346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2515 NEWTON ST",
"city": "JASPER",
"state": "IN",
"postal_code": "475461329",
"telephone_number": "812-482-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2515 NEWTON ST",
"city": "JASPER",
"state": "IN",
"postal_code": "475461329",
"telephone_number": "812-482-1722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERMERSEIM",
"first_name": "KENDALL",
"middle_name": "RENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-13",
"last_updated": "2023-01-13",
"certification_date": "2023-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22007407A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jasper, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.