NPIMap

Individual provider Active NPI

Charlotte Ryburn, MSP, CCC-SLP, L-SP

  • Speech-Language Pathologist
  • Gillham, AR
National Provider Identifier
1447416664
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-181 Issued in AR
Practice address
305 S Hornberg Ave
Gillham, AR 71841
Phone
(870) 386-2251
Fax
(870) 386-7731
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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-181 AR Primary

Addresses

Primary practice location

305 S Hornberg Ave
Gillham, AR 71841

Mailing address

P O Box 110
Gillham, AR 71841
Phone (870) 386-2251

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
SP-181ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dequeen-Mena Educational Cooperative Past Accepting new patients
Dequeen Mena Educational Coop Past Accepting new patients

Organizations & group practices 2

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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1447416664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 110",
            "city": "GILLHAM",
            "state": "AR",
            "postal_code": "71841",
            "telephone_number": "870-386-2251",
            "fax_number": "870-386-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S HORNBERG AVE",
            "city": "GILLHAM",
            "state": "AR",
            "postal_code": "71841",
            "telephone_number": "870-386-2251",
            "fax_number": "870-386-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYBURN",
        "first_name": "CHARLOTTE",
        "credential": "MSP, CCC-SLP, L-SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP-181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillham, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.