Active NPI
Shaunda Brewer, MCD,CCC-SLP
- Speech-Language Pathologist
- Paragould, AR
National Provider Identifier
1164562674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 6061 Greene 707
Paragould, AR 72450-7826 - Phone
- (870) 236-0633
- NPI assigned
- Feb 7, 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 | Primary |
Addresses
Primary practice location
6061 Greene 707
Paragould, AR 72450-7826
Mailing address
PO Box 2581
Jonesboro, AR 72402-2581
Phone (870) 236-0633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159617721 | Medicaid | AR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317168000000",
"number": "1164562674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2581",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724022581",
"telephone_number": "870-236-0633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6061 GREENE 707",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724507826",
"telephone_number": "870-236-0633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "SHAUNDA",
"credential": "MCD,CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2011-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "159617721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paragould, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.