Susan Jean Bolls, MSE,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

469 Issued in AR

Practice address

9403 Dorsey Rd
Jacksonville, AR 72076-8659

Phone

(501) 988-5809

NPI assigned

Apr 30, 2008

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 30, 2011.

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1003082082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9403 DORSEY RD",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720768659",
            "telephone_number": "501-988-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9403 DORSEY RD",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720768659",
            "telephone_number": "501-988-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLS",
        "first_name": "SUSAN",
        "middle_name": "JEAN",
        "name_prefix": "Miss",
        "credential": "MSE,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Jacksonville, AR
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.