Active NPI
Jaime Tennyson, M.S., CCC-SLP
- Speech-Language Pathologist
- Conifer, CO
National Provider Identifier
1710966973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12071582
- Practice address
- 13325 Shiloh Rd
Conifer, CO 80433-5103 - Phone
- (303) 910-1554
- Fax
- (303) 484-2524
- NPI assigned
- Jan 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 12071582 | Primary |
Addresses
Primary practice location
13325 Shiloh Rd
Conifer, CO 80433-5103
Mailing address
13325 Shiloh Rd
Conifer, CO 80433-5103
Phone (303) 910-1554
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32781393 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200616000816 | CO | Practitioner - Qualified Speech Language Pathologist | 8628490984 | Practice locations: Conifer, CO |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Conifer, CO 80433
Phone (303) 910-1554
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457136000000",
"number": "1710966973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13325 SHILOH RD",
"city": "CONIFER",
"state": "CO",
"postal_code": "804335103",
"telephone_number": "303-910-1554",
"fax_number": "303-484-2524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13325 SHILOH RD",
"city": "CONIFER",
"state": "CO",
"postal_code": "804335103",
"telephone_number": "303-910-1554",
"fax_number": "303-484-2524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENNYSON",
"first_name": "JAIME",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-15",
"last_updated": "2016-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": "12071582",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32781393",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conifer, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.