Jennifer Kruidenier

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7327 Issued in SC

Practice address

111 Haywain Dr
Chapin, SC 29036-8204

Phone

(803) 586-1447

NPI assigned

Jul 7, 2021

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 SC

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Murray Speech Pathology LLC

  • Speech-Language Pathologist
  • Chapin, SC
  • NPI 1922732759
  Medicare reassignment NPD Authorized official
• Acker Physical Therapy

  • Physical Therapy Clinic/Center
  • Columbia, SC
  • NPI 1245772755
  Medicare reassignment NPD

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1356912836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HAYWAIN DR",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368204",
            "telephone_number": "803-586-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HAYWAIN DR",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368204",
            "telephone_number": "803-586-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUIDENIER",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "7327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Kiser
• Margaret Elizabeth Kitchens, LISW-C, CEAP
• Renee Lynn Kleppe-Bach, OTR/L
• Nicole Knight, MCD, CCC-SLP
• Jonathan W Krause, DC
• Lake Murray Chiropractic
• Lake Murray Pain and Rehab
• Lake Murray Pain and Rehab, LLC
• Lake Murray Speech Pathology LLC
• Lakeside Healthcare Inc

• Speech-Language Pathologist in Chapin, SC
• Providers in Chapin, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.