Individual provider Active NPI

Dee Misenheimer Lance, PHD, CCC/SLP

  • Speech-Language Pathologist
  • Conway, AR
National Provider Identifier
1093367666
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1448 Issued in AR
Practice address
201 Donaghey Ave
Conway, AR 72035-5001
Phone
(501) 450-5480
Fax
(501) 450-5474
NPI assigned
Jul 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 1448 AR Primary

Addresses

Primary practice location

201 Donaghey Ave
Conway, AR 72035-5001

Mailing address

201 Donaghey Ave
Conway, AR 72035-5001
Phone (501) 450-5480

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1448ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Central Arkansas Speech-Language Pathologist PastSince Feb 13, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1093367666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DONAGHEY AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720355001",
            "telephone_number": "501-450-5480",
            "fax_number": "501-450-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DONAGHEY AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720355001",
            "telephone_number": "501-450-5480",
            "fax_number": "501-450-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCE",
        "first_name": "DEE",
        "middle_name": "MISENHEIMER",
        "credential": "PHD, CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "1448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.