Active NPI
Kerry Ann Dalton, MCD, CCC-SLP
- Speech-Language Pathologist
- Jonesboro, AR
National Provider Identifier
1104940600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 925
- Practice address
- 505 E Matthews Ave
Jonesboro, AR 72401-3144 - Phone
- (870) 932-9567
- Fax
- (870) 932-9576
- NPI assigned
- Mar 19, 2007
- 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 | 925 | AR | Primary |
Addresses
Primary practice location
505 E Matthews Ave
Jonesboro, AR 72401-3144
Mailing address
3312 Saint Andrews CV
Jonesboro, AR 72401-8023
Phone (870) 910-6823
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300601 | Other | AR | HOME HEALTH PROVIDER # |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 925 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104940600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3312 SAINT ANDREWS CV",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724018023",
"telephone_number": "870-910-6823",
"fax_number": "870-931-7103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 E MATTHEWS AVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724013144",
"telephone_number": "870-932-9567",
"fax_number": "870-932-9576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALTON",
"first_name": "KERRY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MCD, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "925",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOME HEALTH PROVIDER #",
"identifier": "300601",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.