Jeri-Leigh M. Konicek, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA2458 Issued in FL

Practice address

127 Spinnaker Cir
South Daytona, FL 32119-8559

Phone

(386) 761-0959

NPI assigned

Jul 23, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Speech Works Pediatric Therapy, LLC

  • Clinic/Center
  • Palm Coast, FL
  • NPI 1245488121

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1407056948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 SPINNAKER CIR",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321198559",
            "telephone_number": "386-761-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 SPINNAKER CIR",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321198559",
            "telephone_number": "386-761-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONICEK",
        "first_name": "JERI-LEIGH",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA2458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Kling LMT
• Amber Marie Kingsley, DC, DIBCN
• Marsha Lyn Klopfenstein
• Maimi Kobayashi
• Sandra Koch
• Susan Kowalczyk
• Trent Gregory Kozman, D.C.
• Dennis Andrew Kuack, DDS
• James Kulis, APRN
• Gerald Stephen Kyer, LICSW

• Speech-Language Pathologist in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.