Individual provider Active NPI

Rebekah Ann Luetkemeyer, SLP

  • Speech-Language Pathologist
  • Jefferson City, MO
National Provider Identifier
1831510379
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
101980 Issued in MO
Practice address
1024 Adams St
Jefferson City, MO 65101-3408
Phone
(573) 635-1320
NPI assigned
Dec 31, 2013
Last updated
Dec 31, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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 101980 MO Primary

Addresses

Primary practice location

1024 Adams St
Jefferson City, MO 65101-3408

Mailing address

304 2ND St
Rocheport, MO 65279-9835
Phone (573) 864-6622

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
101980MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1831510379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 2ND ST",
            "city": "ROCHEPORT",
            "state": "MO",
            "postal_code": "652799835",
            "telephone_number": "573-864-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 ADAMS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013408",
            "telephone_number": "573-635-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETKEMEYER",
        "first_name": "REBEKAH",
        "middle_name": "ANN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-31",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "101980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.