Sharalee Coughran
Individual provider Active NPI Speech-Language Pathologist · Lowell, AR
NPI 1508026642 · NPPES record last updated Jan 7, 2011
Key facts
- NPI
- 1508026642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP1536 (AR)
- Practice address
- 519 Latham Dr
Lowell, AR 72745-8360 - Phone
- (479) 750-0125
- Fax
- (479) 750-0323
- NPI assigned
- Jun 12, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101203001201 | AR | Practitioner - Qualified Speech Language Pathologist | 7911194832 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP1536 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Children'S Hospital | Current |
Accepting new patients | |
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| Arkansas Childrens Hospital | Current |
Accepting new patients | |
| University of Arkansas for Medical Sciences | Current |
Accepting new patients | |
| University of Arkansas for Medical Sciences | Current |
Accepting new patients |
Locations
1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874
1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006
1 Childrens Way
Ste 653
Little Rock, AR 72202
519 Latham Dr
Lowell, AR 72745
Phone (479) 750-0125
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP1536 | AR | Yes |
Addresses
Primary practice location
519 Latham Dr
Lowell, AR 72745-8360
Mailing address
519 Latham Dr
Lowell, AR 72745-8360
Phone (479) 750-0125
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 142552721 | Medicaid | AR |
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All providers in Lowell, AR · Speech-Language Pathologist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.