Jaclyn Walter, M.S. CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

ST4176 Issued in ME

Practice address

15 Anchor Dr
Rockport, ME 04856-3846

Phone

(207) 301-6374

NPI assigned

Oct 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jac Walter Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Mainehealth

  dba MaineHealth Pen Bay Hospital

  • General Acute Care Hospital
  • Rockport, ME
  • NPI 1578043378
  NPD (past)

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1881412369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 LINCOLNVILLE AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049157411",
            "telephone_number": "518-703-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ANCHOR DR",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563846",
            "telephone_number": "207-301-6374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Northport Ave",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156072",
            "country_code": "US",
            "telephone_number": "207-505-4441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTER",
        "first_name": "JACLYN",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST4176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAC",
            "last_name": "WALTER",
            "credential": "M.S. CF-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abebech Jobir Waktola, MD
• Elisabeth Walker Frederick, CNM
• Robert Brian Wall, NP
• Mark Allen Wallace, D.O.
• Patrick T. Walsh, MT
• Mikala Walton, PMHNP-BC
• Thomas Waterhouse
• Colin Tiernan Waters, MD, PHD
• Donald J Weaver, MD
• Marie E. Weferling

• Speech-Language Pathologist in Rockport, ME
• Providers in Rockport, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.