Active NPI
Star Therapy, P.a.
- Speech-Language Pathologist
- Green Forest, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 613
- Legal business name
- STAR THERAPY, P.A.
- Practice address
- 909 W Main St
Green Forest, AR 72638-2316 - Phone
- (870) 423-9246
- Fax
- (877) 425-4393
- NPI assigned
- Apr 23, 2007
- Last updated
- Oct 6, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Carol Fry, M.S., CCC-SLP
- Title
- Speech Pathologist
- Phone
- (870) 553-2284
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 613 | AR | Primary |
Addresses
Primary practice location
909 W Main St
Green Forest, AR 72638-2316
Mailing address
161 County Road 9951
Green Forest, AR 72638-4022
Phone (870) 423-9246
Other practice location 1
706 S Main St
Berryville, AR 72616-4333
Phone (870) 423-9246
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129993742 | Medicaid | AR | |
| 119425721 | Medicaid | AR |
National Provider Directory
National Provider DirectoryLocations
706 S Main St
Berryville, AR 72616
Phone (870) 423-5950
909 W Main St
Green Forest, AR 72638
Phone (870) 423-9246
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Speech-Language Pathologist
- Green Forest, AR
- NPI 1194932848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601942400000",
"number": "1467670372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 COUNTY ROAD 9951",
"city": "GREEN FOREST",
"state": "AR",
"postal_code": "726384022",
"telephone_number": "870-423-9246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 W MAIN ST",
"city": "GREEN FOREST",
"state": "AR",
"postal_code": "726382316",
"telephone_number": "870-423-9246",
"fax_number": "877-425-4393"
}
],
"practiceLocations": [
{
"address_1": "706 S Main St",
"address_purpose": "LOCATION",
"city": "Berryville",
"state": "AR",
"postal_code": "726164333",
"country_code": "US",
"telephone_number": "870-423-9246",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "STAR THERAPY, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-23",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A",
"authorized_official_last_name": "FRY",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "CAROL",
"authorized_official_title_or_position": "SPEECH PATHOLOGIST",
"authorized_official_telephone_number": "870-553-2284",
"authorized_official_credential": "M.S., CCC-SLP"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "613",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129993742",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119425721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Forest, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.