Jan Harris Lundgren, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7674 Issued in NC

Practice address

208 Mercer Mill Rd
Elizabethtown, NC 28337

Phone

(910) 862-6400

Fax

(910) 247-2413

NPI assigned

Sep 10, 2009

Last updated

Aug 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jan Boyd Harris Former name

Medicare fee-for-service enrollment

Enrolled in NC, FL, VA3 enrollments

Enrollment records 3

Specialty

Qualified Speech Language Pathologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dysphagia Management Systems, LLCGroup PAC ID 4385920040, 3 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.

• Dysphagia Management Systems, LLC

  • Hearing and Speech Clinic/Center
  • Sarasota, FL
  • NPI 1194196592

  NC, VA

  Medicare reassignment Care Compare group
• Pulmonary Associates of Richmond Inc

  • Specialist
  • Richmond, VA
  • NPI 1144253444
  NPD

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1467785253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6509 WYNBROOK WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122370",
            "telephone_number": "941-928-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MERCER MILL RD",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-6400",
            "fax_number": "910-247-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "JAN",
        "middle_name": "HARRIS",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "HARRIS",
            "middle_name": "BOYD",
            "prefix": "MS.",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Liberty Healthcare Group, LLC (Liberty Home Care, LLC)
• Liberty Nursing Services, LLC (Liberty Nursing Services)
• Kelly Linville
• Courtney Alyson Lloyd, MSW
• Angie Evans Lowry, FNP
• Jennie Grace Madden, BCBA
• Ashley B Marlowe, FNP
• Andrew B McCorison, PA-C
• McLean Family Care Home
• McLean Family Care Home 2

• Speech-Language Pathologist in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.