Individual provider Active NPI

Mary Kinsey Lenderman, MS, CCC/SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1386326437
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
119778 Issued in TX
Practice address
5310 N Tarrant Pkwy Ste 152
Fort Worth, TX 76244-7300
Phone
(817) 514-6333
Fax
(817) 514-6334
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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 119778 TX Primary

Addresses

Primary practice location

5310 N Tarrant Pkwy Ste 152
Fort Worth, TX 76244-7300

Mailing address

4536 Spring View LN Apt 6301
Fort Worth, TX 76244-5970

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
119778TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jump Start Pediatric Therapy Center, LLC Speech-Language Pathologist PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 1

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1386326437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4536 SPRING VIEW LN APT 6301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 N TARRANT PKWY STE 152",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762447300",
            "telephone_number": "817-514-6333",
            "fax_number": "817-514-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENDERMAN",
        "first_name": "MARY KINSEY",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "119778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.