Individual provider Active NPI

Jadee Hentges

  • Speech-Language Pathologist
  • Apple Valley, MN
National Provider Identifier
1598255333
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9879 Issued in MN
Practice address
14635 Pennock Ave Ste 300
Apple Valley, MN 55124-6588
Phone
(651) 994-9644
NPI assigned
May 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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 9879 MN Primary

Addresses

Primary practice location

14635 Pennock Ave Ste 300
Apple Valley, MN 55124-6588

Mailing address

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930
Phone (651) 994-9644

Other practice location 1

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930
Phone (651) 994-9644

Other identifiers 1

IdentifierTypeStateIssuer
9879OtherMNSPEECH AND LANGUAGE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9879MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Therapy Ctr, Inc Speech-Language Pathologist PastSince Jul 27, 2018 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, 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": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1598255333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211930",
            "telephone_number": "651-994-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14635 PENNOCK AVE STE 300",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246588",
            "telephone_number": "651-994-9644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2795 Pilot Knob Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551211930",
            "country_code": "US",
            "telephone_number": "651-994-9644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENTGES",
        "first_name": "JADEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-17",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH AND LANGUAGE LICENSE",
            "identifier": "9879",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.