Individual provider Active NPI

Susan Lynn Currie Jensema, SLP

  • Speech-Language Pathologist
  • Sheboygan, WI
National Provider Identifier
1336476431
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2516-154 Issued in WI
Practice address
3014 Erie Ave
Sheboygan, WI 53081-3658
Phone
(920) 453-7045
NPI assigned
Nov 10, 2009
Last updated
Nov 10, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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 2516-154 WI Primary

Addresses

Primary practice location

3014 Erie Ave
Sheboygan, WI 53081-3658

Mailing address

3014 Erie Ave
Sheboygan, WI 53081-3658
Phone (920) 453-7045

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
2516-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1336476431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813658",
            "telephone_number": "920-453-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813658",
            "telephone_number": "920-453-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CURRIE JENSEMA",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2516-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.