Individual provider Active NPI

Mallory Hindsley

  • Speech-Language Pathologist
  • Newport, AR
National Provider Identifier
1497081905
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#P8225 Issued in AR
Practice address
400 N Pecan St
Castleberry Elementary School
Newport, AR 72112-4075
Phone
(870) 523-1341
Fax
(870) 523-1341
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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#P8225 AR Primary

Addresses

Primary practice location

400 N Pecan St
Castleberry Elementary School
Newport, AR 72112-4075

Mailing address

400 N Pecan St
Castleberry Elementary School
Newport, AR 72112-4075
Phone (870) 523-1341

Other identifiers 1

IdentifierTypeStateIssuer
178527721MedicaidAR

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#P8225ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1497081905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PECAN ST",
            "address_2": "CASTLEBERRY ELEMENTARY SCHOOL",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721124075",
            "telephone_number": "870-523-1341",
            "fax_number": "870-523-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PECAN ST",
            "address_2": "CASTLEBERRY ELEMENTARY SCHOOL",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721124075",
            "telephone_number": "870-523-1341",
            "fax_number": "870-523-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDSLEY",
        "first_name": "MALLORY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#P8225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178527721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, AR

Sources for this page

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