Individual provider Active NPI

Lisa J McKee, M.S., SLP-CCC

  • Speech-Language Pathologist
  • Gravette, AR
National Provider Identifier
1366636953
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2120 Issued in AR
Practice address
601 El Paso St SE
Gravette, AR 72736-8743
Phone
(479) 631-9571
Fax
(479) 787-4120
NPI assigned
Aug 28, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2120 AR Primary

Addresses

Primary practice location

601 El Paso St SE
Gravette, AR 72736-8743

Mailing address

PO Box 1177
Gentry, AR 72734-1177
Phone (479) 631-9571

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2120ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1366636953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1177",
            "city": "GENTRY",
            "state": "AR",
            "postal_code": "727341177",
            "telephone_number": "479-631-9571",
            "fax_number": "479-787-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EL PASO ST SE",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727368743",
            "telephone_number": "479-631-9571",
            "fax_number": "479-787-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "M.S., SLP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "2120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gravette, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.