Individual provider Active NPI

Enny Cleaveland-Acklin

  • Speech-Language Pathologist
  • Springfield, TN
National Provider Identifier
1003225798
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#P8803 Issued in AR
Practice address
3131 Tom Austin Hwy
Springfield, TN 37172-4801
Phone
(615) 382-7979
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#P8803 AR Primary

Addresses

Primary practice location

3131 Tom Austin Hwy
Springfield, TN 37172-4801

Mailing address

1732 N Garland Ave
Fayetteville, AR 72703-2110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP#P8803ARMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1003225798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 N GARLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 TOM AUSTIN HWY",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724801",
            "telephone_number": "615-382-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEAVELAND-ACKLIN",
        "first_name": "ENNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#P8803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.