Active NPI
Jordan Brooke Guerra
- Speech-Language Assistant
- Amarillo, TX
National Provider Identifier
1831619915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 40209
- Practice address
- 1901 Medi Park Dr Ste 2048
Amarillo, TX 79106-2109 - Phone
- (806) 353-2101
- NPI assigned
- Jun 21, 2017
- Last updated
- Jun 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 40209 | TX | Primary |
Addresses
Primary practice location
1901 Medi Park Dr Ste 2048
Amarillo, TX 79106-2109
Mailing address
14918 Mescalero TRL
Amarillo, TX 79118-3422
Phone (940) 655-8300
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40209 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Health Services, Inc. | 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, 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": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498003200000",
"number": "1831619915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14918 MESCALERO TRL",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791183422",
"telephone_number": "940-655-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 MEDI PARK DR STE 2048",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062109",
"telephone_number": "806-353-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRA",
"first_name": "JORDAN",
"middle_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-21",
"last_updated": "2017-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "40209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.