Jennifer Marie Nealis, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP.0004452 Issued in CO

Practice address

1826 Deep Woods LN
Fort Collins, CO 80524-2370

Phone

(727) 560-8758

NPI assigned

Jun 5, 2012

Last updated

Apr 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Jennifer Marie Cole Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Chickadee Speech Therapy, LLC

  • Speech-Language Pathologist
  • Fort Collins, CO
  • NPI 1508509043
  NPD Authorized official
• Acg Therapy Center, Inc

  • Behavior Analyst
  • Gainesville, FL
  • NPI 1588651921

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1831450055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 DEEP WOODS LN",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242370",
            "telephone_number": "727-560-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 DEEP WOODS LN",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242370",
            "telephone_number": "727-560-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEALIS",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12476",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ5770",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0004452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "COLE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NCMC Specialty Clinic
• Sampson Ndikum
• Mark Neagle, M.D.
• Ann Renee Neal, CRNA
• Susannah G Neal, LAC
• Lauren Nebbergall
• Stephanie Necessary
• Brady Neely, LPC
• William A. Neff, M.D.
• Nicole Neidert

• Speech-Language Pathologist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.