Jesse C Polewchak, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12119414

Practice address

9375 Cresthill LN
Highlands Ranch, CO 80130-4408

Phone

(303) 387-2574

NPI assigned

Dec 20, 2023

Last updated

Feb 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1992574883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11407 YELLOW TIP PT",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801344091",
            "telephone_number": "970-390-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9375 CRESTHILL LN",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801304408",
            "telephone_number": "303-387-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEWCHAK",
        "first_name": "JESSE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "12119414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Highlands Ranch, CO
• Providers in Highlands Ranch, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.