Individual provider Active NPI

Jennifer Elizabeth Redanz, CCC-SLP

  • Speech-Language Pathologist
  • Tonawanda, NY
National Provider Identifier
1841573219
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
011039 Issued in NY
Practice address
600 Fletcher St
Tonawanda, NY 14150-3616
Phone
(716) 694-7660
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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 011039 NY Primary

Addresses

Primary practice location

600 Fletcher St
Tonawanda, NY 14150-3616

Mailing address

244 Grimsby Rd
Tonawanda, NY 14223-1921
Phone (716) 875-6922

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tonawanda City School District Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1841573219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 GRIMSBY RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142231921",
            "telephone_number": "716-875-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FLETCHER ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141503616",
            "telephone_number": "716-694-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDANZ",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.