Individual provider Active NPI

Ryanne Fetzer, MS-CCC

  • Speech-Language Pathologist
  • Forked River, NJ
National Provider Identifier
1972483642
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01343500 Issued in NJ
Practice address
620 Lacey Rd Ste 4
Forked River, NJ 08731-2244
Phone
(609) 200-1118
NPI assigned
Sep 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 41YS01343500 NJ Primary

Addresses

Primary practice location

620 Lacey Rd Ste 4
Forked River, NJ 08731-2244

Mailing address

620 Lacey Rd Ste 4
Forked River, NJ 08731-2244
Phone (609) 200-1118

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
41YS01343500NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1972483642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 LACEY RD STE 4",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087312244",
            "telephone_number": "609-200-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 LACEY RD STE 4",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087312244",
            "telephone_number": "609-200-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETZER",
        "first_name": "RYANNE",
        "credential": "MS-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01343500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forked River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.