Jennifer Shin

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

897-PROV Issued in SD

Practice address

200 East Havens
Mitchell, SD 57301

Phone

(605) 995-6370

Fax

(605) 995-6374

NPI assigned

Jul 10, 2020

Last updated

Jul 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1336767854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1284",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573017284",
            "telephone_number": "605-995-6370",
            "fax_number": "605-995-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EAST HAVENS",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "57301",
            "telephone_number": "605-995-6370",
            "fax_number": "605-995-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SD",
            "license": "897-PROV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Jo Sebert, FNP-BC
• Clinton Lyle Seifert, MD
• Teah Serr
• Sheila D. Grieve Optometry, Prof. LLC (Envision Eye Care)
• Patricia Larson Shields, AUD
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 022)
• Shopko Stores Operating Co. LLC (ShopKo Optical 022)
• Richard Joseph Skorey, MD
• Brittany Jean Smith, LMT
• Kelly Don Smith, MD

• Speech-Language Pathologist in Mitchell, SD
• Providers in Mitchell, SD by specialty
• Speech-Language Pathologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.