Individual provider Active NPI

Jenny Lyn Hepokoski, OTR/L

  • Speech-Language Pathologist
  • Fridley, MN
National Provider Identifier
1770747354
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8380 Issued in MN
Practice address
5155 E River Rd
#403
Fridley, MN 55421-1025
Phone
(763) 572-2519
Fax
(763) 572-2616
NPI assigned
Jul 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8380 MN Primary

Addresses

Primary practice location

5155 E River Rd
#403
Fridley, MN 55421-1025

Mailing address

5155 E River Rd
#403
Fridley, MN 55421-1025
Phone (763) 572-2519

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
8380MNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1770747354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD",
            "address_2": "#403",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554211025",
            "telephone_number": "763-572-2519",
            "fax_number": "763-572-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD",
            "address_2": "#403",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554211025",
            "telephone_number": "763-572-2519",
            "fax_number": "763-572-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPOKOSKI",
        "first_name": "JENNY",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.