Individual provider Active NPI

Destiny Grady

  • Speech-Language Assistant
  • Fort Smith, AR
National Provider Identifier
1265105506
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
203754 Issued in AR
Practice address
1501 S Waldron Rd
Fort Smith, AR 72903-2574
Phone
(479) 329-1471
NPI assigned
Jul 30, 2021
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 203754 AR Primary

Addresses

Primary practice location

1501 S Waldron Rd
Fort Smith, AR 72903-2574

Mailing address

1501 S Waldron Rd
Fort Smith, AR 72903-2574
Phone (479) 329-1471

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": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1265105506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-329-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-329-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "DESTINY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AR",
            "license": "203754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.