Lake Murray Speech Pathology LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

LAKE MURRAY SPEECH PATHOLOGY LLC

Practice address

111 Haywain Dr
Chapin, SC 29036-8204

Phone

(803) 586-1447

NPI assigned

Jul 16, 2022

Last updated

Jul 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Kruidenier, MCD, CCC-SLPNPI 1356912836

Title

Speech Language Pathologist

Phone

(803) 586-1447

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Kruidenier

  • Speech-Language Pathologist
  • Chapin, SC
  • NPI 1356912836
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1657929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657929600000",
    "number": "1922732759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HAYWAIN DR",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368204",
            "telephone_number": "803-586-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HAYWAIN DR",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368204",
            "telephone_number": "803-586-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MURRAY SPEECH PATHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-16",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A",
        "authorized_official_last_name": "KRUIDENIER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "803-586-1447",
        "authorized_official_credential": "MCD, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan W Krause, DC
• Jennifer Kruidenier
• Lake Murray Chiropractic
• Lake Murray Pain and Rehab
• Lake Murray Pain and Rehab, LLC
• Lakeside Healthcare Inc
• Candice Elaine Landin, PHARM D.
• Jordan Langhough, RD
• Lauren Lavigne, PHARMD
• Lesley Lawrimore, PT

• Speech-Language Pathologist in Chapin, SC
• Providers in Chapin, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.