Individual provider Active NPI

Judy Ann Jenner, M.S.

  • Speech-Language Pathologist
  • Naples, FL
National Provider Identifier
1982959318
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA10437 Issued in FL
Practice address
671 Goodlette Rd N
Suite 140
Naples, FL 34102-5469
Phone
(239) 434-9512
Fax
(239) 643-5908
NPI assigned
Jul 23, 2012
Last updated
Jul 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA10437 FL Primary

Addresses

Primary practice location

671 Goodlette Rd N
Suite 140
Naples, FL 34102-5469

Mailing address

873 Carrick Bend Cir Apt 101
Naples, FL 34110-4601
Phone (661) 599-6769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200729003629 FL Practitioner - Qualified Speech Language Pathologist 1658796255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ippolito Rehabilitation LLCGroup PAC ID 5092061457, 16 clinicians

Practice addresses (Care Compare)

3569 Pilot Cir
Naples, FL 34120-0714
Phone (239) 390-3978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Ippolito Rehabilitation, LLC CurrentSince Jul 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1982959318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "873 CARRICK BEND CIR APT 101",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341104601",
            "telephone_number": "661-599-6769",
            "fax_number": "239-643-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 GOODLETTE RD N",
            "address_2": "SUITE 140",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025469",
            "telephone_number": "239-434-9512",
            "fax_number": "239-643-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNER",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA10437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.