Active NPI
Jamie Eisenbeis, MHS, CCC-SLP
- Speech-Language Pathologist
- Saint Louis, MO
National Provider Identifier
1003458761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2017030048
- Practice address
- 3115 S Grand Blvd Ste 224
Saint Louis, MO 63118-1047 - Phone
- (314) 312-2357
- NPI assigned
- Oct 15, 2019
- Last updated
- Oct 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2017030048 | MO | Primary |
Addresses
Primary practice location
3115 S Grand Blvd Ste 224
Saint Louis, MO 63118-1047
Mailing address
6038 Hancock Ave
Saint Louis, MO 63139-1920
Other names 1
- Miss Jamie Teague
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Unsure |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2017030048 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Come Play, STL LLC | Multi-Specialty | Past | 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": "1571097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571097600000",
"number": "1003458761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6038 HANCOCK AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631391920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3115 S GRAND BLVD STE 224",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631181047",
"telephone_number": "314-312-2357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISENBEIS",
"first_name": "JAMIE",
"name_prefix": "Mrs.",
"credential": "MHS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-15",
"last_updated": "2019-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2017030048",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Unsure",
"affiliation": "N",
"address_1": "3115 S Grand Blvd Ste 224",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631181047",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JAMIE",
"last_name": "TEAGUE",
"prefix": "MISS",
"credential": "MHS, CCC-SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.