Individual provider Active NPI

Jennifer Eck Lewallen, SLP

  • Speech-Language Pathologist
  • Emporia, KS
National Provider Identifier
1366623985
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2594 Issued in KS
Practice address
1201 W 12TH Ave
Emporia, KS 66801-2504
Phone
(620) 343-6800
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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 2594 KS Primary

Addresses

Primary practice location

1201 W 12TH Ave
Emporia, KS 66801-2504

Mailing address

1030 W Highland Rd
Howell, MI 48843-8701
Phone (517) 546-9000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2594KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Level Eleven Saginaw, LLC CurrentSince Oct 1, 2023 Accepting new patients
Level Eleven Howell, LLC CurrentSince Sep 24, 2023 Accepting new patients

Locations

1030 W Highland Rd
Howell, MI 48843
Phone (517) 546-9000

5815 Bay Rd
Ste 400
Saginaw, MI 48604
Phone (989) 447-2538

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1366623985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 W HIGHLAND RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438701",
            "telephone_number": "517-546-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W 12TH AVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012504",
            "telephone_number": "620-343-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWALLEN",
        "first_name": "JENNIFER",
        "middle_name": "ECK",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.