Active NPI
Jaimie Darlene Ecklund, SLP ASSISTANT
- Speech-Language Assistant
- College Station, TX
National Provider Identifier
1295262640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 38458
- Practice address
- 2700 Earl Rudder Fwy S Ste 1200
College Station, TX 77845-2810 - Phone
- (979) 307-5850
- NPI assigned
- May 16, 2017
- Last updated
- May 16, 2017
- 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 Assistant | 2355S0801X | 38458 | TX | Primary |
Addresses
Primary practice location
2700 Earl Rudder Fwy S Ste 1200
College Station, TX 77845-2810
Mailing address
3600 Major St Unit a
Bryan, TX 77802-2214
Phone (361) 652-5359
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 |
|---|---|---|---|
| 38458 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Health Services, Inc. | Past | Accepting new patients | |
| Epic Health Services, Inc. | Past | Accepting new patients |
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, 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": "1494892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494892800000",
"number": "1295262640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 MAJOR ST UNIT A",
"city": "BRYAN",
"state": "TX",
"postal_code": "778022214",
"telephone_number": "361-652-5359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 EARL RUDDER FWY S STE 1200",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778452810",
"telephone_number": "979-307-5850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKLUND",
"first_name": "JAIMIE",
"middle_name": "DARLENE",
"credential": "SLP ASSISTANT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-16",
"last_updated": "2017-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "38458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.