Kolby Jackson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

46 Royal Rose Dr
Manvel, TX 77578-3377

Phone

(832) 385-3140

NPI assigned

Sep 11, 2019

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)

Enrolled

State licenses

Practice roles

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.

• Pathfinder Pediatrics Home Care, LLC

  • Home Health Agency
  • Katy, TX
  • NPI 1134371651
  NPD (past)

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1184273153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ROYAL ROSE DR",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775783377",
            "telephone_number": "832-304-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 ROYAL ROSE DR",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775783377",
            "telephone_number": "832-385-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KOLBY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illianas Angel Healthcare LLC
• Inclusive Home Care Services, LLC
• Infinity Family Clinic
• Inner Harmony Counseling & Wellness PLLC
• Amanze Iwuanyanwu, RN
• Sharlotte Jackson, LPC
• Stephen Craig Janecek, M.D.
• Daisy Jia, RPH
• Bisola Johnson Adu
• Moriah Johnson, OTR/L

• Speech-Language Pathologist in Manvel, TX
• Providers in Manvel, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.