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JACK RICHARD WARDER
NPI 1467202945
Speech-Language Pathologist in Petoskey, MI

Active since March 26, 2024
347 CREEKSIDE DR, PETOSKEY, MI 49770(231) 487-0080 Get Directions Write a Review

NPPES record last updated: March 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Richard Warder NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK RICHARD WARDER (NPI 1467202945) is an individual speech-language pathologist provider in Petoskey, Michigan and active in the NPI registry since March 2024. He is a graduate of Other (2024).

NPPES Registry Identity

NPI1467202945
Entity TypeIndividualMale
Primary Taxonomy235Z00000X
Provider Legal NameJACK RICHARD WARDER
Location Address347 CREEKSIDE DRPetoskey, MI 49770-8676
Mailing Address1565 Bear Creek Ln Unit MPetoskey, MI 49770-8371 · (307) 433-4655
Phone(231) 487-0080
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 26, 2024
NPPES CertifiedMarch 26, 2024
✔ NPI 1467202945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
347 CREEKSIDE DR, Petoskey, MI 49770
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Richard Warder is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517433303
PECOS Enrollment IDI20260420000814

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH MARIE MANSFIELD OTRL
Occupational Therapist (Neurorehabilitation)
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (231) 487-0080
PETOSKEY SPINE REHAB
Physical Therapist
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (231) 420-0517
MRS. CARRIE R CRAWFORD OTR/L
Occupational Therapist
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (231) 487-0080
MELANIE ELIZABETH MCARTHUR MS, OTRL
Occupational Therapist
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (989) 732-3508
TAMARA KUHN PT
Physical Therapist
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (231) 487-0080
JENNIFER A BRABANT
Speech-Language Pathologist
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (231) 487-0080
EMILY WIRTZ OT/L
Occupational Therapist
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (231) 487-0080
TAYLOR JOELLE MOORE
Speech-Language Pathologist
347 CREEKSIDE DR
PETOSKEY, MI 49770
Emmet County (231) 487-0080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Warder's NPI number?

The NPI number for Jack Warder is 1467202945. It was assigned to this individual provider in the NPPES registry on March 26, 2024.

Where is Jack Warder located?

Jack Warder practices at 347 Creekside Dr, Petoskey, MI 49770. The listed phone number is (231) 487-0080.

What is Jack Warder's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Jack Warder enrolled in Medicare?

Yes. Jack Warder is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Warder was last updated on March 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.