Individual provider Active NPI

Jenafer Rebecca Lewis, SLP

  • Speech-Language Pathologist
  • Bentonville, AR
National Provider Identifier
1437495991
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2011035384 Issued in MO
Practice address
3300 SW Stonepoint Ave
Bentonville, AR 72713-4374
Phone
(816) 738-3441
NPI assigned
Jan 2, 2013
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 2011035384 MO Primary

Addresses

Primary practice location

3300 SW Stonepoint Ave
Bentonville, AR 72713-4374

Mailing address

3300 SW Stonepoint Ave
Bentonville, AR 72713-4374
Phone (816) 738-3441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724004173 MO Practitioner - Qualified Speech Language Pathologist 0345576682 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011035384MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jun 25, 2019 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Fox Rehabilitation Services SLP Mo LLC Speech-Language Pathologist CurrentSince Oct 1, 2023 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jun 25, 2019 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

3330 Ehlmann Rd
Saint Charles, MO 63301
Phone (636) 205-1056

10199 Woodfield Ln
Saint Louis, MO 63132
Phone (314) 485-5845

1131 E Lakewood St
Springfield, MO 65810
Phone (417) 429-3666

1650 High St
Washington, MO 63090
Phone (636) 390-3290

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1437495991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 SW STONEPOINT AVE",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727134374",
            "telephone_number": "816-738-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 SW STONEPOINT AVE",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727134374",
            "telephone_number": "816-738-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JENAFER",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2011035384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.