NPIMap

Organization Active NPI

Pediatric Speech Solutions, LLC

  • Speech-Language Pathologist
  • Wynne, AR
National Provider Identifier
1427715986
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PEDIATRIC SPEECH SOLUTIONS, LLC
Practice address
1938 Falls Blvd N
Wynne, AR 72396-4027
Phone
(870) 588-5190
Fax
(870) 621-2283
NPI assigned
Nov 19, 2021
Last updated
Nov 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Authorized official

Name
Jessie Morris, MCD, CCC-SLPNPI 1518293562
Title
Speech-Language Pathologist
Phone
(870) 588-5190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1938 Falls Blvd N
Wynne, AR 72396-4027

Mailing address

1938 Falls Blvd N
Wynne, AR 72396-4027
Phone (870) 588-5190

Other identifiers 1

IdentifierTypeStateIssuer
210594721MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Pediatricspeechsolutionsllc@gmail.com Other

National Provider Directory

National Provider Directory

Locations

1938 Falls Blvd N
Wynne, AR 72396
Phone (870) 530-6002

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1427715986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 FALLS BLVD N",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964027",
            "telephone_number": "870-588-5190",
            "fax_number": "870-621-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 FALLS BLVD N",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964027",
            "telephone_number": "870-588-5190",
            "fax_number": "870-621-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPEECH SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "870-588-5190",
        "authorized_official_credential": "MCD, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210594721",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pediatricspeechsolutionsllc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Pediatric Speech Solutions LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "None",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "1938 Falls Blvd N",
            "city": "Wynne",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723964027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.