Jacklyn Sarah Rendfrey, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00717400 Issued in NJ

Practice address

12 Windingbrook Dr
Atco, NJ 08004-2902

Phone

(856) 767-2903

NPI assigned

Feb 15, 2013

Last updated

Feb 15, 2013By the provider in NPPES

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 NJ

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Spine and Pain LLCGroup PAC ID 0648358234, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Advanced Spine and Pain LLC

  dba Relievus

  • Interventional Pain Medicine Physician
  • Hammonton, NJ
  • NPI 1730359084

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Advanced Spine and Pain, LLC

  dba Relievers

  • Interventional Pain Medicine Physician
  • Cherry Hill, NJ
  • NPI 1407002124
  NPD
• Advanced Spine and Pain, LLC

  • Pain Medicine Physician
  • Phoenixville, PA
  • NPI 1740996586
  NPD
• Advanced Spine and Pain, LLC

  dba Relievus

  • Pain Medicine Physician
  • Egg Harbor Township, NJ
  • NPI 1447885116
  NPD (past)

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

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1376883165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WINDINGBROOK DR",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080042902",
            "telephone_number": "856-767-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WINDINGBROOK DR",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080042902",
            "telephone_number": "856-767-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDFREY",
        "first_name": "JACKLYN",
        "middle_name": "SARAH",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-15",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00717400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Pinto, MSOT OTR/L
• Precision Counseling LLC
• Donna Putignano, BCBA
• Robert Reich, D.C.
• Ronald Stephen Reid, B.A.
• Rha Health Services NJ LLC
• Rite Aid of New Jersey Inc (Rite Aid Pharmacy 01866)
• Amanda Rosso
• Steven G Russell, MA
• S Warren Gross MD LLC

• Speech-Language Pathologist in Atco, NJ
• Providers in Atco, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.