Jack Richard Warder

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

347 Creekside Dr
Petoskey, MI 49770-8676

Phone

(231) 487-0080

NPI assigned

Mar 26, 2024

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Male

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

Enrolled in MI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therapy Solutions LLCGroup PAC ID 6406896448, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Therapy Solutions LLC

  • Occupational Therapist
  • Petoskey, MI
  • NPI 1578009304

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1467202945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 BEAR CREEK LN UNIT M",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708371",
            "telephone_number": "307-433-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 CREEKSIDE DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708676",
            "telephone_number": "231-487-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDER",
        "first_name": "JACK",
        "middle_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Walsh-Hoobler, LMSW
• Lauren Marie Walsh, O.T., CHT
• Barbara Jean Wamsley, R.PH
• Allison Wang
• Eugene P. Wang, D.O.
• Brynn Warner
• Jeffrey B Washington, M.D.
• Christina Marie Waugh, NP-C
• Wayward Minds Counseling Services, LLC
• Natalie Weber, MA,LLP

• Speech-Language Pathologist in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.