Active NPI
Sarah E Jacobs, M.S. CCC-SLP
- Speech-Language Pathologist
- Wasilla, AK
National Provider Identifier
1912269499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4573
- Practice address
- 650 N Shoreline Dr
Wasilla, AK 99654 - Phone
- (907) 376-6363
- NPI assigned
- Jun 11, 2012
- 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 Pathologist | 235Z00000X | 4573 | TN | Primary |
Addresses
Primary practice location
650 N Shoreline Dr
Wasilla, AK 99654
Mailing address
613 S Knik Goose Bay Rd Ste B
Wasilla, AK 99654-8090
Phone (907) 631-3056
Other practice location 1
9040 Executive Park Dr
Suite 105
Knoxville, TN 37923-4640
Phone (407) 739-4068
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4573 | TN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reading Write Alaska Inc | Speech-Language Pathologist | 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 and National Provider Directory roles.
-
- Speech-Language Pathologist
- Anchorage, AK
- NPI 1376849133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589673600000",
"number": "1912269499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 S KNIK GOOSE BAY RD STE B",
"city": "WASILLA",
"state": "AK",
"postal_code": "996548090",
"telephone_number": "907-631-3056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 N SHORELINE DR",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654",
"telephone_number": "907-376-6363"
}
],
"practiceLocations": [
{
"address_1": "9040 Executive Park Dr",
"address_2": "Suite 105",
"address_purpose": "LOCATION",
"city": "Knoxville",
"state": "TN",
"postal_code": "379234640",
"country_code": "US",
"telephone_number": "407-739-4068",
"fax_number": "865-769-0801",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS",
"first_name": "SARAH",
"middle_name": "E",
"name_prefix": "Miss",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-11",
"last_updated": "2020-05-17",
"certification_date": "2020-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "4573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.