NPIMap

Organization Active NPI

Jamie Slagel Lac LLC

Doing business as Eagle Cap Wellness

  • Physical Therapist
  • Enterprise, OR
National Provider Identifier
1013504208
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JAMIE SLAGEL LAC LLC
Doing business as
Eagle Cap Wellness
Practice address
616 W North St
Enterprise, OR 97828-1427
Phone
(541) 398-8318
Fax
(541) 960-3904
NPI assigned
Dec 22, 2020
Last updated
Dec 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Dr. Jamie Kimball, DACMNPI 1841697984
Title
Owner
Phone
(541) 398-8318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

616 W North St
Enterprise, OR 97828-1427

Mailing address

616 W North St
Enterprise, OR 97828-1427
Phone (541) 398-8318

Other names 1

  • Eagle Cap Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1013504208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W NORTH ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281427",
            "telephone_number": "541-398-8318",
            "fax_number": "541-960-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W NORTH ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281427",
            "telephone_number": "541-398-8318",
            "fax_number": "541-960-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMIE SLAGEL LAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-398-8318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DACM"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Cap Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enterprise, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.