Individual provider Active NPI

Brooke Renee Jehle

  • Speech-Language Pathologist
  • Independence, MO
National Provider Identifier
1407498181
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2017024497 Issued in MO
Practice address
3980 South Jackson Drive
Independence, MO 64057
Phone
(816) 795-1433
NPI assigned
Oct 14, 2019
Last updated
Oct 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2017024497 MO Primary

Addresses

Primary practice location

3980 South Jackson Drive
Independence, MO 64057

Mailing address

2782 Arrow Creek CT
Wentzville, MO 63385-2648
Phone (636) 385-8816

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL https://nhc.matrixcare.com/
Other URL https://nhc.matrixcare.com/

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

LicenseStateTypeSpecialty
2017024497MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1407498181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2782 ARROW CREEK CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633852648",
            "telephone_number": "636-385-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SOUTH JACKSON DRIVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64057",
            "telephone_number": "816-795-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEHLE",
        "first_name": "BROOKE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2017024497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://nhc.matrixcare.com/",
            "affiliation": "N",
            "address_1": "3980 South Jackson Drive",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "64057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://nhc.matrixcare.com/",
            "affiliation": "N",
            "address_1": "3980 South Jackson Drive",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "64057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.