Kimberly Anne Pearson, MSP, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · NLR, AR
NPI 1295057727 · NPPES record last updated Feb 25, 2010
Key facts
- NPI
- 1295057727
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP 627 (AR)
- Practice address
- 2200 Poplar St
NLR, AR 72115 - Phone
- (501) 771-8093
- Fax
- (501) 771-8090
- NPI assigned
- Feb 25, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 627 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pulaski County Tri-District Early Childhood Program | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP 627 | AR | Yes |
Addresses
Primary practice location
2200 Poplar St
NLR, AR 72115
Mailing address
4 Norfork CV
Maumelle, AR 72113-6538
Phone (501) 626-3181
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133154-721 | Medicaid | AR |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.