Active NPI
Lara Lewis, MCD,CCC-SLP
- Speech-Language Pathologist
- Walnut Ridge, AR
National Provider Identifier
1508024134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#1606
- Practice address
- 211 W Hickory St
Walnut Ridge, AR 72476-2648 - Phone
- (870) 886-3212
- Fax
- (870) 886-3224
- NPI assigned
- May 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#1606 | AR | Primary |
Addresses
Primary practice location
211 W Hickory St
Walnut Ridge, AR 72476-2648
Mailing address
3702 Bolt Blvd
Jonesboro, AR 72401-8045
Phone (870) 268-8393
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP#1606 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Educational Cooperative | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Walnut Ridge, AR
- NPI 1962545806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212105600000",
"number": "1508024134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3702 BOLT BLVD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724018045",
"telephone_number": "870-268-8393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 W HICKORY ST",
"city": "WALNUT RIDGE",
"state": "AR",
"postal_code": "724762648",
"telephone_number": "870-886-3212",
"fax_number": "870-886-3224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "LARA",
"name_prefix": "Mrs.",
"credential": "MCD,CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-30",
"last_updated": "2008-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#1606",
"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 May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.