Payton Lynn Brazeal

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

202340 Issued in AR

Practice address

17706 Interstate 30 N Ste 3
Benton, AR 72019-2930

Phone

(501) 315-4414

NPI assigned

Aug 3, 2023

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 3, 2023.

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1124700638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17706 INTERSTATE 30 N STE 3",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17706 INTERSTATE 30 N STE 3",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192930",
            "telephone_number": "501-315-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZEAL",
        "first_name": "PAYTON",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "202340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Brannen, RECOVERY ASSISTANT
• Misty Bransford
• Lauren Brantley
• Claire Branton
• Clay B Brashears, M.D.
• Joshua Brazzell, CMP
• Tiffany Brennan, RECOVERY ASSISTANT
• Socorro Brestel, PROGRAM TECH/MHPP
• Billie Brewer, CRNA
• Jim Ed Brewer, M.D.

• All providers in Benton, AR
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.