Active NPI
Jennifer L. White, M.S., CCC-SLP
- Speech-Language Pathologist
- Devils Lake, ND
National Provider Identifier
1437480084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1058
- Practice address
- 801 5TH Ave SE
Devils Lake, ND 58301-3649 - Phone
- (701) 662-2769
- Fax
- (701) 662-7684
- NPI assigned
- Jan 21, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1058 | ND | Primary |
Addresses
Primary practice location
801 5TH Ave SE
Devils Lake, ND 58301-3649
Mailing address
801 5TH Ave SE
Devils Lake, ND 58301-3649
Phone (701) 662-2769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55578 | Medicaid | ND |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1058 | ND | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Region Special Education | Speech-Language Pathologist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Occupational Therapist
- Devils Lake, ND
- NPI 1902904121
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264032000000",
"number": "1437480084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 5TH AVE SE",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583013649",
"telephone_number": "701-662-2769",
"fax_number": "701-662-7684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 5TH AVE SE",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583013649",
"telephone_number": "701-662-2769",
"fax_number": "701-662-7684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JENNIFER",
"middle_name": "L.",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-21",
"last_updated": "2010-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "1058",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55578",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Devils Lake, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.