Individual provider Active NPI

Jordan Philip Thrasher

  • Speech-Language Pathologist
  • Mountain Home, AR
National Provider Identifier
1003543695
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
201939 Issued in AR
Practice address
3117 Partipilo St
Mountain Home, AR 72653-5855
Phone
(501) 206-4555
NPI assigned
Aug 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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 201939 AR Primary

Addresses

Primary practice location

3117 Partipilo St
Mountain Home, AR 72653-5855

Mailing address

3117 Partipilo St
Mountain Home, AR 72653-5855
Phone (501) 206-4555

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
201939ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1003543695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 PARTIPILO ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726535855",
            "telephone_number": "501-206-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 PARTIPILO ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726535855",
            "telephone_number": "501-206-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THRASHER",
        "first_name": "JORDAN",
        "middle_name": "PHILIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "201939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.