Dequeen Mena Educational Coop

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

License

194666720 Issued in AR

Legal business name

DEQUEEN MENA EDUCATIONAL COOP

Practice address

305 S Hornberg Avenue
Gillham, AR 71841

Phone

(870) 386-2251

Fax

(870) 386-7731

NPI assigned

Mar 27, 2013

Last updated

Mar 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diana Hicks

Title

Early Childhood Coordinator

Phone

(870) 386-2251

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dequeen Mena Educational Coop2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dequeen-Mena Educational Cooperative

  • Local Education Agency (LEA)
  • Gillham, AR
  • NPI 1932269123
  NPD tax ID

Practitioners 2

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.

• Meagan Lyle, M.S. SLP, CFY

  • Speech-Language Pathologist
  • Wickes, AR
  • NPI 1225582810
  NPD (past)
• Charlotte Ryburn, MSP, CCC-SLP, L-SP

  • Speech-Language Pathologist
  • Gillham, AR
  • NPI 1447416664
  NPD (past)

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1336482439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110",
            "city": "GILLHAM",
            "state": "AR",
            "postal_code": "718410110",
            "telephone_number": "870-386-2251",
            "fax_number": "870-386-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S HORNBERG AVENUE",
            "city": "GILLHAM",
            "state": "AR",
            "postal_code": "71841",
            "telephone_number": "870-386-2251",
            "fax_number": "870-386-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEQUEEN MENA EDUCATIONAL COOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "EARLY CHILDHOOD COORDINATOR",
        "authorized_official_telephone_number": "870-386-2251"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "AR",
            "license": "194666720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194666720",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dequeen-Mena Educational Cooperative
• Charlotte Ryburn, MSP, CCC-SLP, L-SP
• Judy Carol Steiner, M.S.,SLP-CCC

• Local Education Agency (LEA) in Gillham, AR
• Providers in Gillham, AR by specialty
• Local Education Agency (LEA) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.