NPIMap

Organization Active NPI

Absolute Pediatric Therapy

  • Speech-Language Pathologist
  • Bentonville, AR
National Provider Identifier
1033646245
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
711 Issued in AR
Legal business name
ABSOLUTE PEDIATRIC THERAPY
Doing business as
Absolute Pediatric Therapy
Practice address
2713 SE I St Ste 5
Bentonville, AR 72712-0078
Phone
(479) 250-4355
Fax
(479) 553-7954
NPI assigned
May 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Ms. Ticia Jones
Title
Office Manager
Phone
(479) 250-4355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 711 AR Primary

Addresses

Primary practice location

2713 SE I St Ste 5
Bentonville, AR 72712-0078

Mailing address

2713 SE I St Ste 5
Bentonville, AR 72712-0078
Phone (479) 250-4355

Other practice location 1

3104 NE 12th St
Bentonville, AR 72712-3717
Phone (479) 544-2734

Other identifiers 1

IdentifierTypeStateIssuer
220393742MedicaidAR

Other names 1

  • Absolute Pediatric Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1033646245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 SE I ST STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727120078",
            "telephone_number": "479-250-4355",
            "fax_number": "479-553-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 SE I ST STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727120078",
            "telephone_number": "479-250-4355",
            "fax_number": "479-553-7954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3104 NE 12th St",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727123717",
            "country_code": "US",
            "telephone_number": "479-544-2734",
            "fax_number": "479-544-2734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ABSOLUTE PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TICIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-250-4355",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220393742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Absolute Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Absolute Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.