Individual provider Active NPI

Bonnie M. Vest, MA CCC-SLP

  • Speech-Language Pathologist
  • Magnolia, AR
National Provider Identifier
1467586164
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#1725 Issued in AR
Practice address
2206 N Jackson
Magnolia, AR 71753-2065
Phone
(870) 510-2841
Fax
(844) 315-7385
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2022

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#1725 AR Primary

Addresses

Primary practice location

2206 N Jackson
Magnolia, AR 71753-2065

Mailing address

2206 N Jackson
Magnolia, AR 71753-2065
Phone (870) 510-2841

Other practice location 1

11630 Highway 98
Stephens, AR 71764-8020
Phone (870) 596-2967

Other identifiers 5

IdentifierTypeStateIssuer
12024497OtherASHA
139686721MedicaidAR
5X283OtherARBCBS
105435OtherTXSTATE LICENSE
1725OtherARSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210517000395 AR Practitioner - Qualified Speech Language Pathologist 8022379445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1725ARMDChiropractor
SP#1725ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appleflats Speech Pathology Clinic Speech-Language Pathologist Current Accepting new patients
Appleflats Speech Pathology Clinic Speech-Language Pathologist CurrentSince Dec 21, 2017 Accepting new patients
Vest Speech Pathology Services Speech-Language Pathologist Current Accepting new patients

Locations

2206 N Jackson
Magnolia, AR 71753
Phone (870) 510-2841

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1467586164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 N JACKSON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532065",
            "telephone_number": "870-510-2841",
            "fax_number": "844-315-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 N JACKSON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532065",
            "telephone_number": "870-510-2841",
            "fax_number": "844-315-7385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11630 Highway 98",
            "address_purpose": "LOCATION",
            "city": "Stephens",
            "state": "AR",
            "postal_code": "717648020",
            "country_code": "US",
            "telephone_number": "870-596-2967",
            "fax_number": "870-596-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEST",
        "first_name": "BONNIE",
        "middle_name": "M.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "12024497",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139686721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5X283",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "105435",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1725",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.