Individual provider Active NPI

Jacob Thomas Padilla, ASL

  • Speech-Language Pathologist
  • Las Cruces, NM
National Provider Identifier
1104553650
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SAH-2025-0068 Issued in NM
Practice address
1090 Med Park Dr.
Las Cruces, NM 88005-3236
Phone
(575) 523-7243
Fax
(575) 525-5641
NPI assigned
Aug 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLPA7463 NM
Speech-Language Pathologist 235Z00000X SAH-2025-0068 NM Primary

Addresses

Primary practice location

1090 Med Park Dr.
Las Cruces, NM 88005-3236

Mailing address

301 Perkins Dr.
Ste C
Las Cruces, NM 88005-3248
Phone (575) 523-7243

Other practice location 1

505 S Main St Ste 249
Las Cruces, NM 88001-1243
Phone (575) 527-5884

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

LicenseStateTypeSpecialty
SAH-2025-0068NMMDSpeech-Language Pathologist
SLPA7463NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces School District No. 2 CurrentSince Aug 7, 2022 Accepting new patients
Direct Therapy Services, LLP Speech-Language Pathologist PastSince Sep 1, 2016 Accepting new patients

Locations

505 S Main St
Ste 249
Las Cruces, NM 88001
Phone (575) 527-5823

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1104553650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PERKINS DR.",
            "address_2": "STE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053248",
            "telephone_number": "575-523-7243",
            "fax_number": "575-525-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 MED PARK DR.",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053236",
            "telephone_number": "575-523-7243",
            "fax_number": "575-525-5641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St Ste 249",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880011243",
            "country_code": "US",
            "telephone_number": "575-527-5884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "credential": "ASL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "SLPA7463",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "SAH-2025-0068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.