Active NPI
Jennifer K Munn, CCC-SLP
- Speech-Language Pathologist
- Milan, NY
National Provider Identifier
1891950226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 016493
- Practice address
- 100 Webster Coon Rd
Milan, NY 12571-4143 - Phone
- (845) 943-1212
- NPI assigned
- Jul 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 100579 | MA | |
| Speech-Language Pathologist | 235Z00000X | 016493 | NY | Primary |
Addresses
Primary practice location
100 Webster Coon Rd
Milan, NY 12571-4143
Mailing address
100 Webster Coon Rd
Milan, NY 12571-4143
Phone (458) 943-1212
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SLP100579 | Other | MA | MASSACHUSSETTS LICENSING BOARD |
| 016493 | Other | NY | NEW YORK STATE SPEECH LANGUAGE PATHOLOGY LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100579 | MA | MD | Interpreter |
| 016493 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1891950226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WEBSTER COON RD",
"city": "MILAN",
"state": "NY",
"postal_code": "125714143",
"telephone_number": "458-943-1212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WEBSTER COON RD",
"city": "MILAN",
"state": "NY",
"postal_code": "125714143",
"telephone_number": "845-943-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNN",
"first_name": "JENNIFER",
"middle_name": "K",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-24",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "100579",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "016493",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSACHUSSETTS LICENSING BOARD",
"identifier": "SLP100579",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE SPEECH LANGUAGE PATHOLOGY LICENSE NUMBER",
"identifier": "016493",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.