Individual provider Active NPI

Jennifer Renee Raynes, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Saint Louis, MO
National Provider Identifier
1427242015
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2003010034 Issued in MO
Practice address
7733 Forsyth Blvd
Saint Louis, MO 63105-1817
Phone
(800) 677-1238
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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 2003010034 MO Primary

Addresses

Primary practice location

7733 Forsyth Blvd
Saint Louis, MO 63105-1817

Mailing address

436 E Halsey St
Republic, MO 65738-2624
Phone (417) 732-5973

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
2003010034MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1427242015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 E HALSEY ST",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "657382624",
            "telephone_number": "417-732-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 FORSYTH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631051817",
            "telephone_number": "800-677-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNES",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2003010034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.