Individual provider Active NPI

Jessie M. Kerchal, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Wauneta, NE
National Provider Identifier
1912333246
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1590 Issued in NE
Practice address
130 N Tecumseh
Wauneta, NE 69045-9726
Phone
(308) 394-5333
Fax
(308) 365-1927
NPI assigned
Sep 18, 2013
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1590 NE Primary

Addresses

Primary practice location

130 N Tecumseh
Wauneta, NE 69045-9726

Mailing address

74322 Avenue 350
Wauneta, NE 69045-7116
Phone (308) 350-0705

Other practice location 1

1017 W 7th St
Wray, CO 80758-1420
Phone (970) 332-4811

Other practice location 2

1313 N Cheyenne St
Benkelman, NE 69021-3074
Phone (308) 423-2204

Other identifiers 1

IdentifierTypeStateIssuer
1912333246MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225000568 NE Practitioner - Qualified Speech Language Pathologist 9335473388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 N Tecumseh
Wauneta, NE 69045-9726
Phone (308) 394-5333

801 W C St
Suite 3
MC Cook, NE 69001-3592
Phone (308) 394-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1590NEMDNeurology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Rehabilitation Services, LLC CurrentSince Jan 5, 2022 Accepting new patients
Wray Community District Hospital Past Accepting new patients

Locations

130 N Tecumseh
Wauneta, NE 69045
Phone (308) 394-5333

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": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1912333246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74322 AVENUE 350",
            "city": "WAUNETA",
            "state": "NE",
            "postal_code": "690457116",
            "telephone_number": "308-350-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N TECUMSEH",
            "city": "WAUNETA",
            "state": "NE",
            "postal_code": "690459726",
            "telephone_number": "308-394-5333",
            "fax_number": "308-365-1927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1017 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Wray",
            "state": "CO",
            "postal_code": "807581420",
            "country_code": "US",
            "telephone_number": "970-332-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1313 N Cheyenne St",
            "address_purpose": "LOCATION",
            "city": "Benkelman",
            "state": "NE",
            "postal_code": "690213074",
            "country_code": "US",
            "telephone_number": "308-423-2204",
            "fax_number": "308-423-2287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERCHAL",
        "first_name": "JESSIE",
        "middle_name": "M.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912333246",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauneta, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.