NPIMap

Organization Active NPI

Jason Fuller

  • Speech-Language Pathologist
  • Searcy, AR
National Provider Identifier
1073891982
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#1372 Issued in AR
Legal business name
JASON FULLER
Practice address
1208 W Pleasure Ave
Searcy, AR 72143-5151
Phone
(501) 230-3916
NPI assigned
Jul 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Authorized official

Name
Mr. Jason Fuller, M.S.CCC-SLPNPI 1972718401
Title
Owner/Speech Pathologist
Phone
(501) 230-3916

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SP#1372 AR Primary

Addresses

Primary practice location

1208 W Pleasure Ave
Searcy, AR 72143-5151

Mailing address

1208 W Pleasure Ave
Searcy, AR 72143-5151
Phone (501) 230-3916

Other identifiers 1

IdentifierTypeStateIssuer
149676742MedicaidAR

Other names 1

  • Clearly Speaking Doing business as

National Provider Directory

National Provider Directory

Locations

1208 W Pleasure Ave
Searcy, AR 72143
Phone (501) 230-3916

Practitioners & affiliated clinicians

Practitioners 4

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": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1073891982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 W PLEASURE AVE",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721435151",
            "telephone_number": "501-230-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 W PLEASURE AVE",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721435151",
            "telephone_number": "501-230-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON FULLER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER/SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "501-230-3916",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S.CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149676742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearly Speaking",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Searcy, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.