Jackson Ogburn

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

2020023671 Issued in MO

Practice address

5195 Magnolia Dr
Joplin, MO 64801-6406

Phone

(417) 684-7415

NPI assigned

Jun 18, 2024

Sex

Male

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)

Not 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.

• Outreach Occupational Therapy LLC

  • Rehabilitation Practitioner
  • Joplin, MO
  • NPI 1740916451
  NPD

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1336982131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5195 MAGNOLIA DR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648016406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5195 MAGNOLIA DR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648016406",
            "telephone_number": "417-684-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBURN",
        "first_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "MO",
            "license": "2020023671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Dawn O/Bryan
• Khaled Obeidat
• Rahul Oberoi, MD
• Cheryl-Gabriella Kamsiyonna Obiadi
• Sydney Ena Obimpeh
• Justin S Ogden, MD
• Mary Rachelle Ogle Walker, MPT
• Coeta Sue Ogle, FNP-C
• Nicole Ogle, FNP-C
• Adetokunbo Olawuyi, BDS, DMSC

• Speech-Language Assistant in Joplin, MO
• Providers in Joplin, MO by specialty
• Speech-Language Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.