Individual provider Active NPI

Macey Kemp

  • Speech-Language Pathologist
  • Bentonville, AR
National Provider Identifier
1407527625
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
201644 Issued in AR
Practice address
2713 SE I St Ste 5
Bentonville, AR 72712-0078
Phone
(479) 250-4355
Fax
(479) 553-7954
NPI assigned
Sep 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 201644 AR Primary

Addresses

Primary practice location

2713 SE I St Ste 5
Bentonville, AR 72712-0078

Mailing address

2713 SE I St Ste 5
Bentonville, AR 72712-0078
Phone (479) 250-4355

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Bentonville Health Information Exchange (HIE)

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

State licenses

LicenseStateTypeSpecialty
201644ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1407527625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 SE I ST STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727120078",
            "telephone_number": "479-250-4355",
            "fax_number": "479-553-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 SE I ST STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727120078",
            "telephone_number": "479-250-4355",
            "fax_number": "479-553-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "MACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "201644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Bentonville",
            "affiliation": "N",
            "endpointDescription": "Fusion EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2713 SE I St Ste 5",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727120078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.