The Speech Path of Nea, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#2403 Issued in AR

Legal business name

THE SPEECH PATH OF NEA, LLC

Practice address

615 Canal Ave E
Wynne, AR 72396-3003

Phone

(870) 588-1997

Fax

(870) 208-8139

NPI assigned

Oct 6, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Ashley Boeckmann King, SLP

Title

Owner/Speech Language Pathologist

Phone

(870) 588-1997

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1164731253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WYNNEWOOD DR N",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723961803",
            "telephone_number": "870-588-1997",
            "fax_number": "870-208-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 CANAL AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963003",
            "telephone_number": "870-588-1997",
            "fax_number": "870-208-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPEECH PATH OF NEA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "BOECKMANN",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "870-588-1997",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#2403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.