Individual provider Active NPI

Jessica Charlene Engstrom, BS, SLP-ASSISTANT

  • Speech-Language Assistant
  • Houston, TX
National Provider Identifier
1417368929
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
35764 Issued in TX
Practice address
14515 Briarhills Parkway
Houston, TX 77504
Phone
(832) 850-2733
NPI assigned
May 19, 2014
Last updated
Jul 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 35764 TX Primary

Addresses

Primary practice location

14515 Briarhills Parkway
Houston, TX 77504

Mailing address

2105 FM 333 Rd
Garwood, TX 77442-4137
Phone (817) 292-8787

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
35764TXMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1417368929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 FM 333 RD",
            "city": "GARWOOD",
            "state": "TX",
            "postal_code": "774424137",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14515 BRIARHILLS PARKWAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77504",
            "telephone_number": "832-850-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGSTROM",
        "first_name": "JESSICA",
        "middle_name": "CHARLENE",
        "name_prefix": "Ms.",
        "credential": "BS, SLP-ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "35764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.