Jason Vitus Fornwald, ED.S, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

520 S 1St Ave
Sioux Falls, SD 57104-6902

Phone

(605) 336-7561

Fax

(605) 330-9820

NPI assigned

Aug 6, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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

• State of South Dakota

  • Speech-Language Pathologist
  • Sioux Falls, SD
  • NPI 1497871933
  NPD (past)

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1780358317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S 1ST AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046902",
            "telephone_number": "605-336-7561",
            "fax_number": "605-330-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 1ST AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046902",
            "telephone_number": "605-336-7561",
            "fax_number": "605-330-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNWALD",
        "first_name": "JASON",
        "middle_name": "VITUS",
        "name_prefix": "Prof.",
        "credential": "ED.S, MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.fornwald@usd.edu",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "520 S 1st Ave",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571046902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Olivia Ford, M.A.
• Kennedy Ann Forest
• Rory Forest
• Jacob Allen Formiller
• Dena Marie Fornwald, MA CCC-SLP
• Renee Forred
• John Elmer Forrette Jr., DPM
• Eric Von Forsberg, I-MD, TND, PHD
• Tamara Jo Forseth, MSW, CSW-PIP
• Claire Forster

• Speech-Language Pathologist in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Speech-Language Pathologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.