Look up the most recent NPI and PECOS records

Jill C Southworth

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Jill C Southworth does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 38 days ago.

Profile Details

Provider ID
1487026407
Provider Type
Individual
Full Name
Southworth, Jill C
Title
Mrs.
Credential
CCC-SLP

Gender
Female
Sole Proprietor
No
Enumeration Date
10/29/2015
Last Updated
10/29/2015

Contact Information

Practice Location

5606 S 147th St, Omaha, NE 68137-2648

(402) 715-8200

Unlisted Fax

Mailing Location

5606 S 147th St, Omaha, NE 68137-2648

(402) 715-8200

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 8427362909	Description Other	Issuer NDE STAFF ID Nebraska

Jill C Southworth

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Giroux, Taylor Lyn

Krizmanich, Britt

Poehlman, Hollin Dale

Griffith, Patti A

Delgado, Olga

Switzer, Allison

Osbourne, Kathryn A

Oneill, Chelsey

Johansen, Sharon

Mcgargill, Samantha Elizabeth