Daniel Enrique Medina, MED, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL010118 Issued in GA

Practice address

1601 Westpark Dr Ste 3
Little Rock, AR 72204-2432

Phone

(501) 664-1717

Fax

(501) 664-1720

NPI assigned

Oct 21, 2010

Last updated

Oct 21, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1407156664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WESTPARK DR STE 3",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722042432",
            "telephone_number": "501-664-1717",
            "fax_number": "501-664-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WESTPARK DR STE 3",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722042432",
            "telephone_number": "501-664-1717",
            "fax_number": "501-664-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "DANIEL",
        "middle_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "credential": "MED, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SL010118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Hearing Associates of Arkansas, LLC
• Medical Hearing Associates of Arkansas, LLC
• Medical Investments of Little Rock, LLC
• Medical Laboratories of Arkansas, Inc.
• Victoria M Medina Carbonell, MD
• Halle Medley, LPC
• Mya Medley
• Rickey D Medlock, M.D.
• Medsurg Inc
• Trevor Meece, MD

• Speech-Language Pathologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.