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Jacey Layne Bullock , MS, CCC-SLP

Speech-Language Pathologist β€’ Aledo, TX

Active NPI 1568717155 Individual Practitioner Female Practitioner
Practice location in NPPES

1015 Champions Dr # 102
Aledo, TX 760083206

Call 2148031699 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1015 Champions Dr # 102

Aledo, TX 760083206

Telephone 2148031699
Organization at the Same NPPES Address or Phone
Klc Pediatric Therapy, Llc Facility NPI 1306629142

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2012

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Aledo and Texas

16 active clinicians are listed under Speech-Language Pathologist with a practice address in Aledo, TX (17,078 in Texas).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Aledo

0% of these 16 clinicians have the CMS telehealth indicator.

0% of these 16 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-08-17
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES TX 36944

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Texas Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
207164901 (TX)
Medicaid ID
149984001 (TX)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location August 17, 2023

Registered at 1015 CHAMPIONS DR # 102, ALEDO, TX 760083206 (Tel: 2148031699)

πŸ“
Updated Business Mailing Address August 17, 2023

Registered at 418 PRAIRIE RUN, ALEDO, TX 760081170 (Tel: 2148031699)

πŸ‘€
Provider Name / Credentials Updated August 17, 2023

Recorded as JACEY BULLOCK, M.S., CCC-SLP

βœ…
NPI Profile Active July 19, 2012

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 19, 2012

Registered at 545 ROWLETT RD, SUITE A, GARLAND, TX 750433700 (Tel: 9723037021)

πŸ“
Business Mailing Address (Initial Record) July 19, 2012

Registered at 5316 TRAIL LAKE DR, FORT WORTH, TX 761331931 (Tel: 8172928787)

πŸ‘€
Provider Name / Credentials (Initial Record) July 19, 2012

Recorded as JACEY TRAVIS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2012

Speech-Language Pathologist (license number reported to NPPES: TX 36944)

🟒
Initial NPI Registration & Enumeration July 19, 2012

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1568717155
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2012
Last Update: August 17, 2023
Sole Proprietor: Yes

Mailing Address

418 Prairie Run

Aledo, TX 760081170

Phone: 2148031699

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.