NPIMap

Organization Active NPI

Kidspot Walnut Ridge2

  • Speech-Language Pathologist
  • Walnut Ridge, AR
National Provider Identifier
1205585288
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
KIDSPOT WALNUT RIDGE2
Practice address
Kidspot
700 West Main
Walnut Ridge, AR 72476
Phone
(870) 637-5903
Fax
(870) 637-5908
NPI assigned
Mar 18, 2022
Last updated
Mar 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Gina DeuterNPI 1508816760
Title
Owner
Phone
(870) 974-9114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU
Physical Therapy Assistant 225200000X NU
Occupational Therapist 225X00000X NU
Speech-Language Assistant 2355S0801X NU
Speech-Language Pathologist 235Z00000X NU Primary
Developmental Therapist 222Q00000X NU

Addresses

Primary practice location

Kidspot
700 West Main
Walnut Ridge, AR 72476

Mailing address

Kidspot
1801 Grant Ave
Jonesboro, AR 72401-6155
Phone (870) 974-9114

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address a.rottinghaus@kidspotnea.com Direct

National Provider Directory

National Provider Directory

Locations

700 W Main St
Walnut Ridge, AR 72476
Phone (870) 637-5903

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1205585288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KIDSPOT",
            "address_2": "1801 GRANT AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016155",
            "telephone_number": "870-974-9114",
            "fax_number": "870-974-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KIDSPOT",
            "address_2": "700 WEST MAIN",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "72476",
            "telephone_number": "870-637-5903",
            "fax_number": "870-637-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPOT WALNUT RIDGE2",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "DEUTER",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-974-9114"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "a.rottinghaus@kidspotnea.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "KidSPOT",
            "address_2": "700 West Main",
            "city": "Walnut Ridge",
            "state": "AR",
            "country_code": "US",
            "postal_code": "72476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Ridge, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.