Individual provider Active NPI

Jennifer Thompson Tetnowski, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Lafayette, LA
National Provider Identifier
1578784203
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4424 Issued in LA
Practice address
1432 S College Rd
Lafayette, LA 70503-2912
Phone
(337) 232-7080
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2008

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 4424 LA Primary

Addresses

Primary practice location

1432 S College Rd
Lafayette, LA 70503-2912

Mailing address

218 Acacia Dr
Lafayette, LA 70508-4004
Phone (337) 261-5495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201118000108 OK Practitioner - Qualified Speech Language Pathologist 0648681973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Stonewall Ave
Oklahoma City, OK 73117-1215
Phone (405) 271-2866

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4424LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Clinic of Lafayette, Inc. Speech-Language Pathologist PastSince Jul 15, 1999 Accepting new patients

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1578784203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 ACACIA DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084004",
            "telephone_number": "337-261-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S COLLEGE RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032912",
            "telephone_number": "337-232-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETNOWSKI",
        "first_name": "JENNIFER",
        "middle_name": "THOMPSON",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "4424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.