Individual provider Active NPI

Jesse Patterson Lentz

  • Speech-Language Assistant
  • Fairbanks, AK
National Provider Identifier
1922844539
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
225916 Issued in AK
Practice address
398 Hamilton Ave
Fairbanks, AK 99701-3537
Phone
(907) 374-4911
NPI assigned
Jul 2, 2024
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 225916 AK Primary

Addresses

Primary practice location

398 Hamilton Ave
Fairbanks, AK 99701-3537

Mailing address

1526 Richard Berry Dr
Fairbanks, AK 99709-5985
Phone (907) 590-9780

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
225916AKMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1922844539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 RICHARD BERRY DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095985",
            "telephone_number": "907-590-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 HAMILTON AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013537",
            "telephone_number": "907-374-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENTZ",
        "first_name": "JESSE",
        "middle_name": "PATTERSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AK",
            "license": "225916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.

Verify at the official NPI Registry.