Jacqueline Rae Sutherland, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

001793 Issued in IA

Practice address

118 E Main St
Anamosa, IA 52205-1871

Phone

(319) 533-2916

NPI assigned

Jan 5, 2009

Last updated

May 19, 2010By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Iowa Speech Therapy, LLC

  • Hearing and Speech Clinic/Center
  • Anamosa, IA
  • NPI 1205132123
  NPD (past)

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1770729329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522050425",
            "telephone_number": "319-533-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E MAIN ST",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522051871",
            "telephone_number": "319-533-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "JACQUELINE",
        "middle_name": "RAE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-05",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "001793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Luke's Jones Regional Medical Center
• St Luke's Jones Regional Medical Center
• St Luke's Jones Regional Medical Center (St Luke's Jones Regional Medical Center Lab)
• St. Luke's Jones Regional Medical Center (Jones Regional Medical Center Physician Services)
• Brooke Stammeyer
• Lawrence A. Taylor, ABOC
• Dana C Thordsen, FNP-C
• Taylor Nicole Tittle
• TLC Healthcare LLC
• Total Eye Health Center Inc

• Speech-Language Pathologist in Anamosa, IA
• Providers in Anamosa, IA by specialty
• Speech-Language Pathologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.