Individual provider Active NPI

Jena Gayl Lovaas, CFY-SLP

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1942041959
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2662 Issued in ND
Practice address
4575 23Rd Ave S Ste 500
Fargo, ND 58104-8784
Phone
(701) 347-1782
NPI assigned
Jun 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 528865 MN
Speech-Language Pathologist 235Z00000X 2662 ND Primary

Addresses

Primary practice location

4575 23Rd Ave S Ste 500
Fargo, ND 58104-8784

Mailing address

713 28TH St N
Fargo, ND 58102-3140
Phone (701) 318-0889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715003496 ND Practitioner - Qualified Speech Language Pathologist 5092250928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Myna Therapy Services PLLCGroup PAC ID 8022499888, 10 clinicians

Practice addresses (Care Compare)

4575 23Rd Ave S
Suite 400
Fargo, ND 58104-8783
Phone (701) 347-1782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2662NDMDSocial Worker
528865MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myna Therapy Services PLLC Speech-Language Pathologist CurrentSince Jun 24, 2024 Accepting new patients
Myna Early Intervention LLC PastSince Jan 26, 2025 Accepting new patients

Locations

4575 23rd Ave S
Ste 400
Fargo, ND 58104
Phone (701) 347-1782

4575 23rd Ave S
Ste 500
Fargo, ND 58104
Phone (701) 347-1782

Organizations & group practices 2

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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1942041959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 28TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023140",
            "telephone_number": "701-318-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 23RD AVE S STE 500",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048784",
            "telephone_number": "701-347-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVAAS",
        "first_name": "JENA",
        "middle_name": "GAYL",
        "credential": "CFY-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528865",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.