Individual provider Active NPI

Jessica Watkins, SLP ASSISTANT

  • Speech-Language Assistant
  • Rockwall, TX
National Provider Identifier
1619342276
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
36024 Issued in TX
Practice address
1136 Hidden Lakes Way
Rockwall, TX 75087-6113
Phone
(214) 724-6211
NPI assigned
Dec 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 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 36024 TX Primary

Addresses

Primary practice location

1136 Hidden Lakes Way
Rockwall, TX 75087-6113

Mailing address

1136 Hidden Lakes Way
Rockwall, TX 75087-6113
Phone (214) 724-6211

Other identifiers 1

IdentifierTypeStateIssuer
36024OtherTXSTATE BOARD OF EXAMINERS SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY

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
36024TXMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1619342276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 HIDDEN LAKES WAY",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750876113",
            "telephone_number": "214-724-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 HIDDEN LAKES WAY",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750876113",
            "telephone_number": "214-724-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JESSICA",
        "credential": "SLP ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "36024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF EXAMINERS SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY",
            "identifier": "36024",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.