Jennifer L Womack, SPEECH LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

24698 Issued in TX

Practice address

2505 Lakeview Dr Ste 302
Amarillo, TX 79109-1523

Phone

(806) 358-8974

Fax

(806) 359-0506

NPI assigned

Mar 29, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629198338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061705",
            "telephone_number": "806-358-8974",
            "fax_number": "806-359-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 LAKEVIEW DR STE 302",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091523",
            "telephone_number": "806-358-8974",
            "fax_number": "806-359-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "24698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182690101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS LINK TO 00BF18",
            "identifier": "87741T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.