Active NPI
McKenna Lynn Zeringue, M.S. CCC SLP
- Speech-Language Pathologist
- Benton, AR
National Provider Identifier
1063163640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8497
- Practice address
- 17706 I 30
Benton, AR 72019-2907 - Phone
- (501) 315-4414
- NPI assigned
- Jan 14, 2022
- Last updated
- Mar 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8497 | AR | Primary |
Addresses
Primary practice location
17706 I 30
Benton, AR 72019-2907
Mailing address
122 Pleasantwood Dr
Maumelle, AR 72113-7071
Phone (731) 695-0187
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 512672 | Medicaid | LA |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8497 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reach Behavioral Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Benton, AR
- NPI 1093379935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709596800000",
"number": "1063163640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 PLEASANTWOOD DR",
"city": "MAUMELLE",
"state": "AR",
"postal_code": "721137071",
"telephone_number": "731-695-0187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17706 I 30",
"city": "BENTON",
"state": "AR",
"postal_code": "720192907",
"telephone_number": "501-315-4414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZERINGUE",
"first_name": "MCKENNA",
"middle_name": "LYNN",
"credential": "M.S. CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-14",
"last_updated": "2024-03-05",
"certification_date": "2024-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "8497",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "512672",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.