KEMBERLEE JACK (NPI# 1609165505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609165505 |
| Entity Type | Individual |
| Full Name | KEMBERLEE JACK |
| Credential | SLPA |
| Practice Address |
1241 Shadybrook Dr Baton Rouge LA 70816-1273 |
| Practice Telephone | 3373085565 |
| Mailing Telephone | 3373085565 |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
35825 | TX | Speech, Language and Hearing Service Providers |
| Street Address |
1241 SHADYBROOK DR |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70816-1273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508324047 | Tunya S. Jack | Nurse Practitioner | 1241 Shadybrook Dr, Baton Rouge, LA 70816-1273 | 2019-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475128 | Exceptional Dental of Coursey, LLC | Dentist | 12045 Coursey Bvld., Baton Rouge, LA 70816 | 2020-10-26 |
| 1780294058 | Yolande Eileen Thomas | Case Manager/Care Coordinator | Array of Hope, 11940 Bricksome Ave, Baton Rouge, LA 70816 | 2020-08-03 |
| 1164052296 | Hoh Palliative Care, LLC | Family Medicine | 4212 American Way, Suite C, Baton Rouge, LA 70816 | 2020-01-16 |
| 1427698778 | Patricia Salton-hobson | Case Manager/Care Coordinator | 3888 S. Sherwood Forest Blvd Bldg II Ste F, Baton Rouge, LA 70816 | 2020-01-14 |
| 1467010447 | Niqueria Von'shea Mcswain | Licensed Practical Nurse | 2455 Weldwood Dr, Apt 6108, Baton Rouge, LA 70816 | 2019-06-04 |
| 1184184665 | Brent C Underwood | Chiropractor | 11851 Coursey Blvd., Baton Rouge, LA 70816 | 2019-03-21 |
| 1720544240 | Titus Randle II | Secured Medical Transport (VAN) | 1234 Pompey Dr, Baton Rouge, LA 70816 | 2019-02-20 |
| 1356820054 | Ashley Wheeler | Social Worker | 1761 Physicians Blvd., Baton Rouge, LA 70816 | 2018-08-13 |
| 1609355783 | Lynda W Thibodeaux | Counselor | 4021 W.e. Heck Court, Building B Suite 2, Baton Rouge, LA 70816 | 2018-08-09 |
| 1083193114 | Akamin Victor Nkengaka | Case Manager/Care Coordinator | Pelican Bayou Counseling Services, 3084 Westfolk Drive, Baton Rouge, LA 70816 | 2018-08-09 |
| Find all providers in zip 70816 | ||||
| Taxonomy Code | 2355S0801X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Speech-Language Assistant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235655762 | Chastity Lamaya Smith | Specialist/Technologist | 1580 Heartwood Dr, Baton Rouge, LA 70816-1439 | 2017-08-16 |
| 1578804290 | Jennifer Clair Landry | Specialist/Technologist | 5422 Superior Dr Ste B, Baton Rouge, LA 70816-6063 | 2013-03-05 |
| 1871878629 | Peer Plus, LLC | Specialist/Technologist | 3631 S Lakeshore Dr, Baton Rouge, LA 70808-3631 | 2011-10-12 |
| 1962946079 | Kayla Buchardt | Specialist/Technologist | 7784 Innovation Park Dr, Baton Rouge, LA 70820-7006 | 2016-12-08 |
| 1154708907 | Lauren M Courtney | Specialist/Technologist | 7784 Innovation Park Dr, Baton Rouge, LA 70820-7006 | 2015-04-30 |
| 1730589680 | John Montelepre Iv | Specialist/Technologist | 5422 Superior Dr, Suite B, Baton Rouge, LA 70816-6063 | 2014-08-28 |
| 1710262555 | Mary Debrueys | Specialist/Technologist | 3631 S Lakeshore Dr, Baton Rouge, LA 70808-3631 | 2011-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342531 | Haley Baker | Specialist/Technologist | 15239 Stones Throw Cir Apt 307, Hammond, LA 70401-7563 | 2020-10-01 |
| 1992358949 | Elizabeth Lockett | Specialist/Technologist | 3347 Deborah Dr, Monroe, LA 71201-2150 | 2019-07-18 |
| 1235619529 | Bernice Hammond-chiasson | Specialist/Technologist | 11 Fontainebleau Dr Apt G, New Orleans, LA 70125-3438 | 2018-08-16 |
| 1629598537 | Keshla Washington | Specialist/Technologist | 36505 Oak Plaza Ave, Suite B, Prairieville, LA 70769 | 2017-06-21 |
| 1306297205 | Holly Beshea | Specialist/Technologist | 7729 Southfork Dr, Shreveport, LA 71105-5721 | 2016-06-22 |
| 1225444136 | Teairra Strozier | Specialist/Technologist | 4544 Paris Ave, New Orleans, LA 70122-2522 | 2014-07-11 |
| 1881912046 | Sheila Hollis | Specialist/Technologist | 4002 Curtis Ln, Shreveport, LA 71109-5016 | 2010-05-12 |
| 1659699361 | Joneisha Thompson Lee | Specialist/Technologist | 216 Hampton St, Houma, LA 70364-1313 | 2010-05-06 |
| 1265759765 | Kryshawn Bell | Specialist/Technologist | 101 Campbell Dr, Ferriday, LA 71334-3724 | 2010-04-23 |
| 1982920518 | The Rehab Group, LLC | Specialist/Technologist | 14092 Serenity Cove, Gonzales, LA 70737 | 2010-04-07 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70816 |
Please comment or provide details below to improve the information on KEMBERLEE JACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.