Pamela K Petray, MA CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP1442 Issued in AR

Practice address

91 Neal St
Hope for Tomorrow
Farmington, AR 72730

Phone

(479) 267-4673

NPI assigned

Aug 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Hope for Tomorrow Pediatric Foundation

  • Occupational Therapist
  • Farmington, AR
  • NPI 1427166768
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497768139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18036 SUNSET RD",
            "city": "WINSLOW",
            "state": "AR",
            "postal_code": "72959",
            "telephone_number": "479-267-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 NEAL ST",
            "address_2": "HOPE FOR TOMORROW",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "72730",
            "telephone_number": "479-267-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAY",
        "first_name": "PAMELA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "MA CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP1442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5X943",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree R Nelson, APRN
• Northwest Ar Esc
• Northwest Ar Esc
• Northwest Arkansas Educational Service Cooperative
• Peachtree Village of Farmington, LLC
• Heather Phillips, M.S., CCC-SLP
• Michelle Nicole Phillips, MD
• Phobos Behavioral of Farmington LLC
• Terri Lynn Pinkham, OTRL
• Playworks Pediatric Therapy and Play Gym, LLC

• Speech-Language Pathologist in Farmington, AR
• Providers in Farmington, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.