NPIMap

Organization Active NPI

Spa, Inc.

  • Speech-Language Pathologist
  • Jonesboro, AR
National Provider Identifier
1043332612
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1842 Issued in AR
Legal business name
SPA, INC.
Practice address
3423 E Highland Dr Ste a
Jonesboro, AR 72401-6404
Phone
(870) 336-0021
Fax
(870) 336-0022
NPI assigned
Apr 4, 2007
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Lori R Malone, MCDCCC-SLP
Title
Speech Language Pathologist
Phone
(870) 336-0021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1842 AR Primary

Addresses

Primary practice location

3423 E Highland Dr Ste a
Jonesboro, AR 72401-6404

Mailing address

3423 E Highland Dr Ste a
Jonesboro, AR 72401-6404
Phone (870) 336-0021

Other identifiers 9

IdentifierTypeStateIssuer
161331721MedicaidAR
145699721MedicaidAR
157682721MedicaidAR
142244721MedicaidAR
145524721MedicaidAR
145811721MedicaidAR
152429721MedicaidAR
148112721MedicaidAR
157521742MedicaidAR

Other names 1

  • Sensational Kids Other name

National Provider Directory

National Provider Directory

Locations

3423 E Highland Dr
Ste A
Jonesboro, AR 72401
Phone (870) 336-9669

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1043332612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 E HIGHLAND DR STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016404",
            "telephone_number": "870-336-0021",
            "fax_number": "870-336-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 E HIGHLAND DR STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016404",
            "telephone_number": "870-336-0021",
            "fax_number": "870-336-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "870-336-0021",
        "authorized_official_credential": "MCDCCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "1842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161331721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145699721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157682721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142244721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145524721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145811721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152429721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148112721",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157521742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sensational Kids",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.