Individual provider Active NPI

Jane Carol Kevorkian

  • Speech-Language Pathologist
  • Somerville, NJ
National Provider Identifier
1629660022
Registry record updated Feb 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00230800 Issued in NJ
Practice address
21 E High St
Somerville, NJ 08876-2320
Phone
(908) 458-6267
NPI assigned
Feb 7, 2021
Last updated
Feb 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 41YS00230800 NJ Primary

Addresses

Primary practice location

21 E High St
Somerville, NJ 08876-2320

Mailing address

30 Big Spring Rd
Califon, NJ 07830-3430
Phone (908) 832-7452

Other practice location 1

30 Big Spring Rd
Califon, NJ 07830-3430
Phone (908) 832-7452

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.northeastspeechservices.com Direct

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
41YS00230800NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1612656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612656000000",
    "number": "1629660022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BIG SPRING RD",
            "city": "CALIFON",
            "state": "NJ",
            "postal_code": "078303430",
            "telephone_number": "908-832-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E HIGH ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762320",
            "telephone_number": "908-458-6267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Big Spring Rd",
            "address_purpose": "LOCATION",
            "city": "Califon",
            "state": "NJ",
            "postal_code": "078303430",
            "country_code": "US",
            "telephone_number": "908-832-7452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEVORKIAN",
        "first_name": "JANE",
        "middle_name": "CAROL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-07",
        "last_updated": "2021-02-07",
        "certification_date": "2021-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00230800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.northeastspeechservices.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Exchange",
            "address_1": "21 E High St",
            "city": "Somerville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088762320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.

Verify at the official NPI Registry.