Individual provider Active NPI

Jennifer Shephard Crouse, MA

  • Speech-Language Pathologist
  • Kalamazoo, MI
National Provider Identifier
1467612747
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
ASHA09119722 Issued in MI
Practice address
1011 W Maple St
Ste 300 Kalamazoo Speech Associates
Kalamazoo, MI 49008
Phone
(269) 343-7811
Fax
(269) 343-7811
NPI assigned
Jun 11, 2008
Last updated
Jul 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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 ASHA09119722 MI Primary

Addresses

Primary practice location

1011 W Maple St
Ste 300 Kalamazoo Speech Associates
Kalamazoo, MI 49008

Mailing address

1011 W Maple St
Ste 300
Kalamazoo, MI 49008-5803
Phone (269) 343-7811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121219000529 MI Practitioner - Qualified Speech Language Pathologist 9032361043 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
ASHA09119722MIMDSpeech-Language Pathologist

Organizations & group practices 2

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500595200000",
    "number": "1467612747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W MAPLE ST",
            "address_2": "STE 300",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490085803",
            "telephone_number": "269-343-7811",
            "fax_number": "269-343-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W MAPLE ST",
            "address_2": "STE 300 KALAMAZOO SPEECH ASSOCIATES",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49008",
            "telephone_number": "269-343-7811",
            "fax_number": "269-343-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUSE",
        "first_name": "JENNIFER",
        "middle_name": "SHEPHARD",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2017-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "ASHA09119722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; 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.