Jayla Rose Jacques, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

201384 Issued in AR

Practice address

702 Hickory St
Arkadelphia, AR 71923-5040

Phone

(870) 464-1337

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

Yes

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.

• Howard Memorial Hospital

  • Surgery Physician
  • Nashville, AR
  • NPI 1215102702

  AR

  Medicare reassignment NPD
• Howard Memorial Hospital

  • Clinical Neuropsychologist
  • Nashville, AR
  • NPI 1104282664
  NPD
• Pearson Pediatric OT Services

  • Pediatrics Physician
  • Texarkana, TX
  • NPI 1629356027

  Speech-Language Pathologist

  NPD

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/howard-9d20da0d

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 21, 2023.

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1972106607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 HICKORY ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235040",
            "telephone_number": "870-464-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 HICKORY ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235040",
            "telephone_number": "870-464-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "JAYLA",
        "middle_name": "ROSE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "201384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Hurst
• Inspired Success LLC
• Fawn Jackson, RPH
• Malissa Jackson
• Shauna D Jackson
• James W. Hankins, D.D.S., P.a.
• Mark T Jansen, M.D.
• Abbey Leanne Janssen, COTA
• Daniel Carl Jarboe, LPC
• David G Jaskey, M.D.

• All providers in Arkadelphia, AR
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.