JESSICA ANN OLDER – Speech-Language Pathologist, NPI 1124189915

JESSICA ANN OLDER is a healthcare provider. based in Parkville, Missouri. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. 2009014885 (MO). The NPI Number for JESSICA ANN OLDER is 1124189915

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA ANN OLDER
NPI
1124189915
Phone
(217) 276-5377
Address
15143 N CHERRY CT
Enumeration Date
13 December 2006
Last Update Date
11 June 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9137899900
Graduation Year
2006 (20 years ago)
PAC ID
5890213516
Group Practice PAC ID
2466641816
Professional Enrollment ID
I20250516001765
Address ID
KS66204XXXXOVXXXXXXXXXX00
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

192 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in MO

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Provider Addresses for JESSICA ANN OLDER

  • 15143, North Cherry Court, Thousand Oaks, Parkville, Platte County, Missouri, 64152, United States

    PARKVILLE, MO 641521640

    Phone: (217) 276-5377

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250516001765IQualified Speech Language PathologistKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64152)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466641816View full group profile
NameSpecialtyState
Qualified Speech Language PathologistKS
Physical Therapist In Private PracticeVA
Qualified Speech Language PathologistKS
Qualified Speech Language PathologistKS
Occupational Therapist In Private PracticeWA
-KS
-KS
-MO
Occupational Therapist In Private PracticeKS
-KS

Reviews

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Frequently asked questions

What NPI should I save for JESSICA ANN OLDER?
Save NPI 1124189915 if you need a stable reference for JESSICA ANN OLDER.
Is JESSICA ANN OLDER active in the national directory?
JESSICA ANN OLDER's public NPI profile is in an active state.
Can you summarize JESSICA ANN OLDER's specialty in plain language?
Clinically, the directory lists JESSICA ANN OLDER with Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
What location shows for JESSICA ANN OLDER?
We surface Parkville, Missouri for JESSICA ANN OLDER based on available NPPES addresses.
Is JESSICA ANN OLDER a real provider?
This page reflects official NPPES data for NPI 1124189915. Always confirm identity and privileges with the practice and licensing boards.

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