Active NPI
Eunjeong NA, CCC-SLP
- Speech-Language Pathologist
- Lincoln, NE
National Provider Identifier
1700908910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1682
- Practice address
- 5930 Vandervoort Dr
Ste a
Lincoln, NE 68516-2391 - Phone
- (402) 420-2099
- Fax
- (402) 420-2823
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1682 | NE | Primary |
Addresses
Primary practice location
5930 Vandervoort Dr
Ste a
Lincoln, NE 68516-2391
Mailing address
5930 Vandervoort Dr
Ste a
Lincoln, NE 68516-2391
Phone (402) 420-2099
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1682 | NE | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438214400000",
"number": "1700908910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5930 VANDERVOORT DR",
"address_2": "STE A",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685162391",
"telephone_number": "402-420-2099",
"fax_number": "402-420-2823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5930 VANDERVOORT DR",
"address_2": "STE A",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685162391",
"telephone_number": "402-420-2099",
"fax_number": "402-420-2823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NA",
"first_name": "EUNJEONG",
"name_prefix": "Ms.",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2015-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "1682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.