Individual provider Active NPI

Richelle Leigh Weese, M.S.CCC-SLP

  • Speech-Language Pathologist
  • Conway, AR
National Provider Identifier
1427168558
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#1143 Issued in AR
Practice address
1500 Museum Rd Ste 104
Conway, AR 72032-4761
Phone
(501) 329-3804
Fax
(501) 329-0718
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 SP#1143 AR Primary

Addresses

Primary practice location

1500 Museum Rd Ste 104
Conway, AR 72032-4761

Mailing address

1500 Museum Rd Ste 104
Conway, AR 72032-4761
Phone (501) 329-3804

Other identifiers 1

IdentifierTypeStateIssuer
5Y682OtherARABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104000591 AR Practitioner - Qualified Speech Language Pathologist 5597156471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Central Arkansas Speech-Language Pathologist CurrentSince Jan 1, 2022 Accepting new patients
University of Central Arkansas Current Accepting new patients
University of Central Arkansas Speech-Language Pathologist PastSince Feb 13, 2022 Accepting new patients

Locations

201 Donaghey Ave
Conway, AR 72035
Phone (501) 450-3136

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427168558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MUSEUM RD STE 104",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324761",
            "telephone_number": "501-329-3804",
            "fax_number": "501-329-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MUSEUM RD STE 104",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324761",
            "telephone_number": "501-329-3804",
            "fax_number": "501-329-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEESE",
        "first_name": "RICHELLE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "M.S.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABCBS",
            "identifier": "5Y682",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.