Active NPI
Kendra Lee Hennegen
- Speech-Language Pathologist
- Sudbury, MA
National Provider Identifier
1528653953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 77920
- Practice address
- 142 North Rd Ste SS
Sudbury, MA 01776-1178 - Phone
- (978) 610-6603
- NPI assigned
- Mar 8, 2021
- 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 | 77920 | MA | Primary |
Addresses
Primary practice location
142 North Rd Ste SS
Sudbury, MA 01776-1178
Mailing address
13 Shepard St Apt 4
Cambridge, MA 02138-1716
Phone (714) 319-6045
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77920 | MA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enjc, Inc | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1528653953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 SHEPARD ST APT 4",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381716",
"telephone_number": "714-319-6045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 NORTH RD STE SS",
"city": "SUDBURY",
"state": "MA",
"postal_code": "017761178",
"telephone_number": "978-610-6603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNEGEN",
"first_name": "KENDRA",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-08",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "77920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sudbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.