Jacque Lynn Jacobs

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2641 Issued in KS

Practice address

2401 Canterbury Dr
Hays, KS 67601-2345

Phone

(785) 628-3241

NPI assigned

Mar 29, 2007

Last updated

Feb 6, 2023By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fort Hays State UniversityGroup PAC ID 8921057365, 4 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fort Hays State University

  dba Herndon Clinic

  • Audiologist
  • Hays, KS
  • NPI 1811101454
  Medicare reassignment Care Compare group NPD
• Fort Hays State University

  dba Herndon Clinic

  • Speech-Language Pathologist
  • Hays, KS
  • NPI 1609080001
  NPD
• Luis S Alonzo MD PA

  • Psychiatry Physician
  • Kinsley, KS
  • NPI 1336218742
  NPD (past)
• Via Christi Village Hays Inc

  dba Ascension Living Via Christi Village Hays

  • Skilled Nursing Facility
  • Hays, KS
  • NPI 1790774982
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1366561102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 JOLIET ST",
            "city": "GORHAM",
            "state": "KS",
            "postal_code": "67640",
            "telephone_number": "785-637-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 CANTERBURY DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012345",
            "telephone_number": "785-628-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JACQUE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "116219",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Marie Ibarra, DNP, APRN-C
• Ignited Path Psychiatry LLC
• Amy Illovsky
• Elliot Isom, LPC
• Andrew B Jacobs, LMSW
• Kim Jacobs, RDN
• Manoj Jagtiani, DO
• Pramod Janga, MD
• Mohammed I Janif, MD, MBBS, FACC
• Lara Kay Jansonius, LMSW

• Speech-Language Pathologist in Hays, KS
• Providers in Hays, KS by specialty
• Speech-Language Pathologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.