Lisa Jurkiewicz

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

09365 Issued in MD

Practice address

1119 State Route 3 N Ste 201
Gambrills, MD 21054-1788

Phone

(443) 808-1218

NPI assigned

Jun 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fleming Therapy Services, LLC

  dba Ivyrehab

  • Speech-Language Pathologist
  • Stafford, VA
  • NPI 1194925818
  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1750763918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3776 PATUXENT RIVER RD",
            "city": "DAVIDSONVILLE",
            "state": "MD",
            "postal_code": "210352419",
            "telephone_number": "443-808-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 STATE ROUTE 3 N STE 201",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541788",
            "telephone_number": "443-808-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURKIEWICZ",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202007908",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "DC",
            "license": "SLP001045",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "09365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Ray Jenkins II
• Jerome S. Casper Childrens Dental Office, P.a.
• JMR Mental Health, LLC (White Rock Christian Counseling)
• John V. Demaio DC PC
• Karen Sue Jordan, OTR/L, C/LT, C/NDT
• Grace Kalakay, L.AC.
• Mary Karvounis, D.D.S.
• Katina Byrd Miles, MD LLC
• Laura Kelly
• Erin Kenawell, CRNP

• Speech-Language Pathologist in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.