Individual provider Active NPI

Maegan Mullen

  • Speech-Language Pathologist
  • Walnut Ridge, AR
National Provider Identifier
1477899938
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
700 W Main St
Walnut Ridge, AR 72476-1849
Phone
(870) 637-5903
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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 Primary

Addresses

Primary practice location

700 W Main St
Walnut Ridge, AR 72476-1849

Mailing address

6309 Julia LN
Jonesboro, AR 72404-7149
Phone (870) 275-8878

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kidspot Walnut Ridge2 Speech-Language Pathologist CurrentSince Sep 17, 2023 Accepting new patients
Tiffany B Ryan Speech-Language Pathologist Past Accepting new patients

Locations

700 W Main St
Walnut Ridge, AR 72476
Phone (870) 637-5903

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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1477899938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 JULIA LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724047149",
            "telephone_number": "870-275-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W MAIN ST",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724761849",
            "telephone_number": "870-637-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "MAEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Ridge, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.