Individual provider Active NPI

Jennifer Lynn Kiernan, M.S.,CCC-SLP

  • Speech-Language Pathologist
  • Lexington, KY
National Provider Identifier
1629249248
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
140091 Issued in KY
Practice address
825 Tiffanie CT
Lexington, KY 40514-4082
Phone
(859) 806-5717
Fax
(859) 208-8980
NPI assigned
Mar 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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 140091 KY Primary

Addresses

Primary practice location

825 Tiffanie CT
Lexington, KY 40514-4082

Mailing address

912 Oatfield Rd
Harrodsburg, KY 40330-2306
Phone (859) 613-4476

Other practice location 1

912 Oatfield Rd
Harrodsburg, KY 40330-2306
Phone (859) 613-4476

Other identifiers 1

IdentifierTypeStateIssuer
7100455250MedicaidKY

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
140091KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilderness Trace Child Development Center Speech-Language Pathologist PastSince Jul 24, 2022 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": "1206230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1629249248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 OATFIELD RD",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "403302306",
            "telephone_number": "859-613-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 TIFFANIE CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405144082",
            "telephone_number": "859-806-5717",
            "fax_number": "859-208-8980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "912 Oatfield Rd",
            "address_purpose": "LOCATION",
            "city": "Harrodsburg",
            "state": "KY",
            "postal_code": "403302306",
            "country_code": "US",
            "telephone_number": "859-613-4476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "140091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100455250",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.