NPIMap

Organization Active NPI

Jackie-D-Yak, LLC

  • Hearing and Speech Clinic/Center
  • Nashville, TN
National Provider Identifier
1831412907
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
License
SP0000002334 Issued in TN
Legal business name
JACKIE-D-YAK, LLC
Practice address
4741 Trousdale Dr Ste 1
Nashville, TN 37220-1340
Phone
(615) 290-5397
Fax
(615) 941-8935
NPI assigned
Mar 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Authorized official

Name
Mrs. Jacqueline Ree Dunn, ED.S, CCC-SLPNPI 1427371269
Title
Owner
Phone
(615) 476-7261

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X SP0000002334 TN Primary

Addresses

Primary practice location

4741 Trousdale Dr Ste 1
Nashville, TN 37220-1340

Mailing address

PO Box 516
Antioch, TN 37011-0516
Phone (615) 290-5397

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220524000100 TN Part B Supplier - Clinic/Group Practice 9830220078 Receives reassigned benefits from 1 practitioner
Practice locations: Nashville, TN

National Provider Directory

National Provider Directory

Locations

4741 Trousdale Dr
Ste 1
Nashville, TN 37220
Phone (615) 290-5397

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1831412907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370110516",
            "telephone_number": "615-290-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 TROUSDALE DR STE 1",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372201340",
            "telephone_number": "615-290-5397",
            "fax_number": "615-941-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKIE-D-YAK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "REE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-476-7261",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ED.S, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "TN",
            "license": "SP0000002334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.