Individual provider Active NPI

Jaci Langham, RN, CDE

  • Diabetes Educator Registered Nurse
  • Arlington, TX
National Provider Identifier
1740736628
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
770526 Issued in TX
Practice address
4519 Matlock Rd
Suite 135
Arlington, TX 76018-5660
Phone
(817) 472-8180
Fax
(817) 472-7910
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 770526 TX Primary

Addresses

Primary practice location

4519 Matlock Rd
Suite 135
Arlington, TX 76018-5660

Mailing address

4519 Matlock Rd
Suite 135
Arlington, TX 76018-5660
Phone (817) 472-8180

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
770526TXMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dcoa Physicians PA Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1740736628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 MATLOCK RD",
            "address_2": "SUITE 135",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185660",
            "telephone_number": "817-472-8180",
            "fax_number": "817-472-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 MATLOCK RD",
            "address_2": "SUITE 135",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185660",
            "telephone_number": "817-472-8180",
            "fax_number": "817-472-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGHAM",
        "first_name": "JACI",
        "name_prefix": "Mrs.",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "TX",
            "license": "770526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.