Jacie Poe, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

114130 Issued in TX

Practice address

4425 W Wadley Ave Unit 230-a
Midland, TX 79707-5330

Phone

(432) 900-2095

Fax

(432) 400-2676

NPI assigned

Nov 3, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1306501481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 WOODLAND PARK AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797051908",
            "telephone_number": "432-900-2095",
            "fax_number": "432-400-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 W WADLEY AVE UNIT 230-A",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075330",
            "telephone_number": "432-900-2095",
            "fax_number": "432-400-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "JACIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "billing@lekkerspeech.com",
            "affiliation": "N",
            "address_1": "4425 W Wadley Ave Unit 230-A",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797075330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Christian Poldrack, DC
• Hannah Politz
• Sarah Popek
• Patrick R Pornan, LPTA

• All providers in Midland, TX
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.