Jackie Larsen
NPI 1659050177ActiveIndividual· Speech-Language Pathologist· Springville, UT
Speech-Language Pathologist in Springville, Utah, trained at University of Hawaii John A. Burns School of Medicine (class of 2018). Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1659050177 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jul 12, 2023 |
| Last updated in NPPES | Jul 12, 2023 |
| Certified by provider | Jul 12, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 115154024102 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (UT) |
|---|
Education and affiliations
| Medical school | University of Hawaii John A. Burns School of Medicine |
|---|---|
| Graduation year | 2018 |
| Medicare specialty | Qualified Speech Language Pathologist |
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