Individual provider Active NPI

Alexis Nichole Weber, M.S.

  • Speech-Language Pathologist
  • Benton, AR
National Provider Identifier
1134743412
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
17706 Interstate 30 N Ste 3
Benton, AR 72019-2930
Phone
(501) 315-4424
NPI assigned
Jun 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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 Primary

Addresses

Primary practice location

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

Mailing address

17706 Interstate 30 N Ste 3
Benton, AR 72019-2930
Phone (501) 920-3689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024000734 AR Practitioner - Qualified Speech Language Pathologist 7416303763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Therapy and Consulting Services, PA CurrentSince Oct 9, 2023 Accepting new patients
Arkansas Enterprises for the Developmentally Disabled, Inc. Past Accepting new patients
Beyond Boundaries, Inc Speech-Language Pathologist Past Accepting new patients

Locations

5532 John F Kennedy Blvd
North Little Rock, AR 72116
Phone (501) 588-3211

Organizations & group practices 3

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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1134743412",
    "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",
            "telephone_number": "501-920-3689"
        },
        {
            "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": "501-315-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "ALEXIS",
        "middle_name": "NICHOLE",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.