Individual provider Active NPI

Anita Raynes Lepelstat, CCC/SLP

  • Speech-Language Pathologist
  • Lakewood, NJ
National Provider Identifier
1629359641
Registry record updated Sep 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
235Z000000X Issued in NJ
Practice address
96 Enclave Blvd
Lakewood, NJ 08701-5783
Phone
(732) 886-3638
NPI assigned
Sep 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00165400 NJ
Speech-Language Pathologist 235Z00000X 235Z000000X NJ Primary

Addresses

Primary practice location

96 Enclave Blvd
Lakewood, NJ 08701-5783

Mailing address

96 Enclave Blvd
Lakewood, NJ 08701-5783
Phone (732) 886-3638

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

LicenseStateTypeSpecialty
235Z000000XNJMDSpeech-Language Pathologist
41YS00165400NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1315008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315008000000",
    "number": "1629359641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 ENCLAVE BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015783",
            "telephone_number": "732-886-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 ENCLAVE BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015783",
            "telephone_number": "732-886-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPELSTAT",
        "first_name": "ANITA",
        "middle_name": "RAYNES",
        "name_prefix": "Ms.",
        "credential": "CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-03",
        "last_updated": "2011-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00165400",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "235Z000000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2011; 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.