Andrea L. Patterson, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#1388 Issued in AR

Practice address

2403 Main Dr Ste 5
Fayetteville, AR 72704-5275

Phone

(479) 966-4883

Fax

(479) 445-6130

NPI assigned

Aug 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1417149394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 MAIN DR STE 5",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727045275",
            "telephone_number": "479-966-4883",
            "fax_number": "479-445-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 MAIN DR STE 5",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727045275",
            "telephone_number": "479-966-4883",
            "fax_number": "479-445-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "ANDREA",
        "middle_name": "L.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004667",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000842003D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134548721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simranben Patel, PTA
• Daniel Patino, DPT
• Jay Patrick, PT, DPT
• Paige Lynn Patrick, P.D.
• Tori Joann Pattermann
• Anthony Banyon Patterson, LCSW
• Misti Pattillo, APN
• Ashley Michelle Patton
• Cynthia Jean Patton, PHD
• Robert Clyde Patton, M.D.

• Speech-Language Pathologist in Fayetteville, AR
• Providers in Fayetteville, 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 Aug 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.