Jennifer Ann Bertino, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-1707 Issued in ID

Practice address

8211 W Ustick Rd
Boise, ID 83704-5756

Phone

(208) 375-3700

Fax

(208) 639-3048

NPI assigned

Nov 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Ann Bertino Polidori Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1992049233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8211 W USTICK RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045756",
            "telephone_number": "208-375-3700",
            "fax_number": "208-639-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 W USTICK RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045756",
            "telephone_number": "208-375-3700",
            "fax_number": "208-639-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTINO",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1707",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "14042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BERTINO POLIDORI",
            "middle_name": "ANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeanette M Berry, RN
• Kyle Cleveland Berry, DC
• Jenny M Berryhill, P.T.
• Phillip Clayton Berryhill, MD
• Erika Simoneau Berryman
• Cassie Jo Bertsch, PHARM.D.
• Benjamin Berzinis, CRNA
• Katie C Best, LCSW
• Bethel Home Care LLC
• Tamara Faye Bethel, FNP

• All providers in Boise, ID
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.