Annie Jack

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2012011146 Issued in MO

Practice address

3980 E Jackson Dr
Independence, MO 64057-2205

Phone

(816) 795-1433

NPI assigned

Jan 12, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Missouri LLCGroup PAC ID 9234402470, shared by 4 NPIs, 207 clinicians

Empowerme Wellness Kansas City, LLCGroup PAC ID 9830504836, shared by 6 NPIs, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Empowerme Rehabilitation Missouri LLC

  • Multi-Specialty Clinic/Center
  • Saint Charles, MO
  • NPI 1417479494

  Speech-Language Pathologist

  Medicare reassignment NPD
• Empowerme Wellness Kansas City, LLC

  • Multi-Specialty Clinic/Center
  • Kansas City, MO
  • NPI 1083208391

  Speech-Language Pathologist

  Medicare reassignment NPD
• Empowerme Rehabilitation Missouri LLC

  • Multi-Specialty Clinic/Center
  • Prairie Village, KS
  • NPI 1205334521

  Speech-Language Pathologist

  Medicare reassignment NPD
• Empowerme Wellness Kansas City, LLC

  • Multi-Specialty Clinic/Center
  • Prairie Village, KS
  • NPI 1124619697

  Speech-Language Pathologist

  Medicare reassignment NPD
• Empowerme Rehabilitation Missouri LLC

  • Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1558932327

  Speech-Language Pathologist

  NPD
• Empowerme Wellness Kansas City, LLC

  • Rehabilitation Clinic/Center
  • Liberty, MO
  • NPI 1174299044
  NPD

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1669861985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 NW PAR DR",
            "city": "GRAIN VALLEY",
            "state": "MO",
            "postal_code": "640297347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 E JACKSON DR",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572205",
            "telephone_number": "816-795-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "ANNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2012011146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Interim Healthcare of Kansas City, Inc.
• Jessica M Isaacson, M.S., CCC-SLP
• Jill C Isabel, MA, PLPC
• Atef F Israel, MD
• Ivna Medical Group LLC
• Sara Jackaway, MA PLPC
• David Shawn Jackel, APRN, FNP-BC
• Jackie Ransom, LPC, LLC
• Jackley Chiropractic Inc.
• Chad Jackley, D.C.

• Speech-Language Pathologist in Independence, MO
• Providers in Independence, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.