Jacob Walker, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

173818 Issued in KY

Practice address

980 Morgantown Rd
Bowling Green, KY 42101-3644

Phone

(270) 495-1312

Fax

(270) 495-1351

NPI assigned

Jul 26, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jake Walker Other name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Kentucky, LLCGroup PAC ID 1850729211, 108 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowerme Rehabilitation Kentucky, LLC

  • Multi-Specialty Clinic/Center
  • Lexington, KY
  • NPI 1275166696

  KY, Single Specialty

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation Kentucky, LLC

  • Rehabilitation Clinic/Center
  • Florence, KY
  • NPI 1669195640
  NPD

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1306360979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 FIELDS DR STE 102",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045341",
            "telephone_number": "270-495-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 MORGANTOWN RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421013644",
            "telephone_number": "270-495-1312",
            "fax_number": "270-495-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JACOB",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-26",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "173818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY SPEECH-LANGUAGE PATHOLOGY LICENSURE",
            "identifier": "242920",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAKE",
            "last_name": "WALKER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Chesney Walker, M.S., CCC-SLP
• Kimberly Nicole Walker, OTD
• Phillip G. Walker, APRN
• Thomas Henry Walker
• Danna Kaye Wallace, MSW, CSW, CABIP
• Ellery Caroline Wallace, MS, CCC-SLP

• All providers in Bowling Green, KY
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.