Individual provider Active NPI

Jacquelyn Linea Jouett, AU.D., CCC-A

  • Audiologist
  • Plano, TX
National Provider Identifier
1790560639
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81686 Issued in TX
Practice address
6300 W Parker Rd Ste G24
Plano, TX 75093-8105
Phone
(972) 378-0633
NPI assigned
Aug 29, 2023
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 81686 TX Primary

Addresses

Primary practice location

6300 W Parker Rd Ste G24
Plano, TX 75093-8105

Mailing address

1900 Knightsbridge Rd # 1-1207
Farmers Branch, TX 75234-1355
Phone (847) 508-3231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231004001875 TX Practitioner - Qualified Audiologist 8325493711 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81686TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Otolaryngology Specialists of North Texas PA CurrentSince Aug 28, 2023 Accepting new patients

Locations

6300 W Parker Rd
Ste G24
Plano, TX 75093
Phone (972) 378-0633

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDGDCA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1790560639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 KNIGHTSBRIDGE RD # 1-1207",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752341355",
            "telephone_number": "847-508-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE G24",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938105",
            "telephone_number": "972-378-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUETT",
        "first_name": "JACQUELYN",
        "middle_name": "LINEA",
        "name_prefix": "Dr.",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.